Journal of magnetic resonance imaging : JMRI · 2026
Exploratory 4D Flow MRI Study of Portal Venous Rotational Flow for High-Risk Esophageal Varices in Cirrhosis.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Park Sungho, Man Moon Chung, Kwon Minseong, Heo Suk Hee, Lee Yun Young, Paek Mun Young, Park Sun Young, Yoon Jae Hyun, Shin Sang Soo, Huh Hyungkyu
Аннотация
BACKGROUND: Bleeding risk assessment of esophageal varices (EVs) is commonly performed in liver cirrhosis. However, existing approaches are often invasive or insufficient to fully capture bleeding risk.
PURPOSE: To investigate portal venous hemodynamics and vessel geometry associated with EVs severity in cirrhotic patients using four-dimensional flow MRI as a noninvasive approach to support clinical risk assessment.
STUDY TYPE: Retrospective.
POPULATION: One-hundred and four cirrhotic patients consisting of patients without EVs (Group 1, n = 48), with low-risk EVs (Group 2, n = 37), and high-risk EVs (Group 3, n = 19).
FIELD STRENGTH/SEQUENCE: 3 T, a three-directional, velocity-encoded gradient echo sequence with Cartesian k-space sampling.
ASSESSMENT: Flow rate, mean velocity, and fractional flow changes in main portal vein (PV); effective vessel diameter and vessel angle; and rotational flow including vorticity, helicity, helical flow intensity (h 2), localized normalized helicity, and vortex volume.
STATISTICAL TESTS: One-way ANOVA with Tukey's post hoc test or Kruskal-Wallis followed by Conover's post hoc test. Receiver operating characteristic (ROC) curve analysis. Significance level set at p < 0.05.
RESULTS: Significant group differences were observed for flow rate at the proximal PV (ε 2 = 0.05) and for mean PV velocity at both proximal (ε 2 = 0.13) and distal locations (η 2 = 0.11). In contrast, neither fractional portal venous flow nor vessel angle measurements differed across groups (p = 0.294 and all p ≥ 0.475, respectively). Among rotational flow biomarkers, vorticity differentiated Group 3 from both Groups 1 and 2 (Group 1: 17.86 ± 3.26 s-1, Group 2: 16.65 ± 4.58 s-1, Group 3: 13.59 ± 3.23 s-1; η 2 = 0.15), with an area under the ROC curve of 0.77 (sensitivity = 0.79, specificity = 0.62).
DATA CONCLUSION: Rotational flow biomarkers may support current risk assessment in cirrhotic patients with high-risk EVs.
EVIDENCE LEVEL: 4.
TECHNICAL EFFICACY: Stage 2.
PURPOSE: To investigate portal venous hemodynamics and vessel geometry associated with EVs severity in cirrhotic patients using four-dimensional flow MRI as a noninvasive approach to support clinical risk assessment.
STUDY TYPE: Retrospective.
POPULATION: One-hundred and four cirrhotic patients consisting of patients without EVs (Group 1, n = 48), with low-risk EVs (Group 2, n = 37), and high-risk EVs (Group 3, n = 19).
FIELD STRENGTH/SEQUENCE: 3 T, a three-directional, velocity-encoded gradient echo sequence with Cartesian k-space sampling.
ASSESSMENT: Flow rate, mean velocity, and fractional flow changes in main portal vein (PV); effective vessel diameter and vessel angle; and rotational flow including vorticity, helicity, helical flow intensity (h 2), localized normalized helicity, and vortex volume.
STATISTICAL TESTS: One-way ANOVA with Tukey's post hoc test or Kruskal-Wallis followed by Conover's post hoc test. Receiver operating characteristic (ROC) curve analysis. Significance level set at p < 0.05.
RESULTS: Significant group differences were observed for flow rate at the proximal PV (ε 2 = 0.05) and for mean PV velocity at both proximal (ε 2 = 0.13) and distal locations (η 2 = 0.11). In contrast, neither fractional portal venous flow nor vessel angle measurements differed across groups (p = 0.294 and all p ≥ 0.475, respectively). Among rotational flow biomarkers, vorticity differentiated Group 3 from both Groups 1 and 2 (Group 1: 17.86 ± 3.26 s-1, Group 2: 16.65 ± 4.58 s-1, Group 3: 13.59 ± 3.23 s-1; η 2 = 0.15), with an area under the ROC curve of 0.77 (sensitivity = 0.79, specificity = 0.62).
DATA CONCLUSION: Rotational flow biomarkers may support current risk assessment in cirrhotic patients with high-risk EVs.
EVIDENCE LEVEL: 4.
TECHNICAL EFFICACY: Stage 2.