Time-resolved 3D cine phase-contrast magnetic resonance imaging (4D-flow MRI) can quantitatively assess portosystemic shunt severity and confirm normalization of portal flow after embolization of large portosystemic shunts
Time-resolved 3D cine phase-contrast magnetic resonance imaging (4D-flow MRI) can quantitatively assess portosystemic shunt severity and confirm normalization of portal flow after embolization of large portosystemic shunts
复制标题
时间分辨三维动态相位对比磁共振成像（4D - 血流MRI）能够定量评估门体分流的严重程度，并确认大型门体分流栓塞后门静脉血流恢复正常。
DOI：
10.1111/hepr.13616
复制
发表时间：
2021-02-22
影响因子：
4.2
通讯作者：
Naganawa, Shinji
中科院分区：
文献类型：
--
作者：
Hyodo, Ryota;Takehara, Yasuo;Naganawa, Shinji
门体分流（PSS）的诊断和严重程度评估是重要的，因为病理学有时会导致严重的肝性脑病，这几乎可以完全通过分流栓塞治疗。目前，PSS的形态学评估主要通过计算机断层扫描进行，超声用于血流评估。在两例PSS相关肝性脑病病例中，我们使用时间分辨三维电影相位对比（4D-flow）磁共振成像（MRI）评估分流栓塞前后的血流。介入前，上级肠系膜静脉主干血流主要为离肝性。然而，介入后4D血流MRI显示肝上级肠系膜静脉血流，门静脉血流量显著增加。4D-flow MRI是多普勒超声检查的理想辅助手段，可对门静脉系统（包括PSS）的形态和血流进行客观和直观评估，并可用于确定PSS栓塞的适应症和结局。
Diagnosis and severity assessments of portosystemic shunts (PSSs) are important because the pathology sometimes results in severe hepatic encephalopathy, which can be treated almost completely by shunt embolization. At present, morphological assessment of PSS is performed mainly by computed tomography, and ultrasound is used for blood flow assessment. In two cases of PSS-related hepatic encephalopathy, we used time-resolved 3D cine phase-contrast (4D-flow) magnetic resonance imaging (MRI) to assess blood flow before and after shunt embolization. Before the intervention, blood flow in the main trunk of the superior mesenteric vein was mostly hepatofugal. However, post-interventional 4D-flow MRI revealed hepatopetal superior mesenteric vein flow with significantly increased portal vein blood flow. 4D-flow MRI is an ideal adjunct to Doppler ultrasonography, allowing for objective and visual assessment of morphology and blood flow of the portal venous system, including PSSs, and is useful in determining the indications for, and outcome of, PSS embolization.