Novel imaging-based approaches for predicting the hepatic venous pressure gradient in a porcine model of liver cirrhosis and portal hypertension
Novel imaging-based approaches for predicting the hepatic venous pressure gradient in a porcine model of liver cirrhosis and portal hypertension
复制标题
基于成像的新方法用于预测肝硬化和门静脉高压猪模型中的肝静脉压力梯度。
DOI：
10.1016/j.lfs.2020.118710
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发表时间：
2021-01-01
期刊：
影响因子：
6.1
通讯作者：
Guo, Qiyong
中科院分区：
文献类型：
--
作者：
Ma, Yujia;Dong, Deshuo;Guo, Qiyong
目的：肝静脉压力梯度（HVPG）对门静脉高压症（PH）的分期和预后判断具有重要意义。然而，HVPG测量具有局限性（例如，侵入性）。本研究探讨的价值，非侵入性的，基于成像的方法，包括磁共振弹性成像（MRE）和体素内非相干运动（IVIM）扩散加权成像（DWI）的预测HVPG在猪模型的肝硬化和PH。主要方法：雄性巴马小型猪被用来建立一个猪模型的肝硬化和PH诱导栓塞。随机分为实验组（n = 12）和对照组（n = 3）。经颈静脉肝内门体分流术（TIPS）前后行HVPG检查。进行MRE和IVIM-DWI，以获得定量参数，包括MRE中的肝脏硬度（LS），IVIM-DWI中的组织扩散率（D），伪扩散系数（D*）和灌注分数（f）。HVPG和参数之间的相关性进行了assessed.Key结果：LS值显着更大的实验组，而f值显着降低，在4，8，12周后栓塞相比，对照组。此外，HVPG在TIPS后即刻显著低于TIPS前。同时，LS和f值在TIPS后显示出显著变化，这些变化与HVPG降低一致。斯皮尔曼分析显示参数（LS和f）与HVPG之间存在显著相关性。最终生成的方程预测HVPG.Significance：研究结果显示HVPG和定量参数之间有很好的相关性，因此，基于成像的技术有潜力作为非侵入性方法预测HVPG。
Aims: Hepatic venous pressure gradient (HVPG) is critical for staging and prognosis prediction of portal hypertension (PH). However, HVPG measurement has limitations (e.g., invasiveness). This study examined the value of non-invasive, imaging-based approaches including magnetic resonance elastography (MRE) and intra-voxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for the prediction of HVPG in a porcine model of liver cirrhosis and PH.Main methods: Male Bama miniature pigs were used to establish a porcine model of liver cirrhosis and PH induced by embolization. They were randomly assigned to an experimental group (n = 12) and control group (n = 3). HVPG was examined before and after transjugular intrahepatic portosystemic shunt (TIPS). MRE and IVIM-DWI were performed to obtain quantitative parameters including liver stiffness (LS) in MRE, tissue diffusivity (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) in IVIM-DWI. The correlation between HVPG and the parameters was assessed.Key findings: LS values were significantly greater in the experimental group, while f values were significantly decreased at 4, 8, and 12 weeks after embolization compared to the control group. Furthermore, HVPG was significantly lower immediately after versus before TIPS. In parallel, LS and f values showed significant alterations after TIPS, and these changes were consistent with a reduction in HVPG. Spearman analysis revealed a significant correlation between the parameters (LS and f) and HVPG. The equation was eventually generated for prediction of HVPG.Significance: The findings show a good correlation between HVPG and the quantitative parameters; thus, imaging-based techniques have potential as non-invasive methods for predicting HVPG.