Hemodynamic measurements with an abdominal 4D flow MRI sequence with spiral sampling and compressed sensing in patients with chronic liver disease.
Hemodynamic measurements with an abdominal 4D flow MRI sequence with spiral sampling and compressed sensing in patients with chronic liver disease.
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DOI：
10.1002/jmri.26305
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发表时间：
2019-04
期刊：
影响因子：
--
通讯作者：
Taouli B
中科院分区：
文献类型：
--
作者：
Bane O;Peti S;Wagner M;Hectors S;Dyvorne H;Markl M;Taouli B
4D Flow MRI在肝脏疾病中的重测/观察者间重复性和诊断价值报告不足。确定使用螺旋4D血流MRI序列进行腹部血管血流定量的再现性/重复性;评估4D血流参数在诊断肝硬化和门脉高压程度中的价值。有前途。52例慢性肝病患者。在1次屏气中采集1.5T/螺旋4D血流。由2名独立观察员识别并分割13条腹部血管，以测量最大和时间平均通过平面速度、净流量和血管横截面积。分别在15例和4例病例中评价了观察者间一致性和重测重复性。使用4D血流参数预测肝硬化和门脉高压的存在和严重程度。Cohen's kappa系数、变异系数（CV）、Bland-Altman检验、Mann-Whitney检验、logistic回归。对于所有合并的血管，测量结果显示观察者之间的一致性可接受，Cohen's kappa=0.70（p<0.001），CV<21%，Bland-Altman偏倚<5%，但一致性上限（[-75%，75%]）。在大血管中的重复性极好（CV=1- 15%，偏倚=1- 25%，巴拉=[4%，150%]），在小血管中的重复性较差（CV=7- 130%，偏倚=10- 200%，巴拉=[8%，190%]）。肝硬化患者右肝静脉的平均速度和脾静脉的平均面积较高（p=0.027/0.0039）。肝中静脉血流量与Child-Pugh评分密切相关（ρ=0.84，p=0.0238），而在脾静脉中流动（ρ= 0.43，p =0.032），时间平均值（ρ= 0.46，p =0.02）和肠系膜上级静脉峰值流速（ρ= 0.45，p =0.032），肾下IVC的峰值流速（ρ= 0.39，p =0.032）与基于影像学的门脉高压评分呈正相关。脾静脉平均面积预测肝硬化[p=0.019; AUC（95%CI）=0.87（0.71，1.00）]和具有临床意义的门静脉高压[p=0.042; AUC（95%CI）=0.78（0.57-0.99）]。螺旋4D血流允许在一次屏气中对腹部血管进行全面评估，具有显著的观察者间重现性，但可变的重测重复性。4D血流可能潜在地反映由于肝硬化和门脉高压引起的血管变化。
The test-retest/interobserver repeatability and diagnostic value of 4D flow MRI in liver disease is under-reported. To determine the reproducibility/repeatability of flow quantification in abdominal vessels using a spiral 4D flow MRI sequence; to assess the value of 4D flow parameters in diagnosing cirrhosis and degree of portal hypertension. Prospective. 52 patients with chronic liver disease. 1.5T/spiral 4D flow acquired in 1 breath-hold. Thirteen abdominal vessels were identified and segmented by 2 independent observers to measure maximum and time-averaged through-plane velocity, net flow and vessel cross-section area. Interobserver agreement and test-retest repeatability were evaluated in 15 and 4 cases, respectively. Prediction of the presence and severity of cirrhosis and portal hypertension was assessed using 4D flow parameters. Cohen’s kappa coefficient, coefficient of variation (CV), Bland-Altman, Mann-Whitney tests, logistic regression. For all vessels combined, measurements showed acceptable agreement between observers, with Cohen’s kappa=0.70(p<0.001), CV<21%, Bland-Altman bias <5%, but high limits of agreement ([−75%,75%]). Test-retest repeatability was excellent in large vessels (CV=1–15%, bias=1–25%, BALA=[4%,150%]), and poor in small vessels (CV=7–130%, bias=10–200%, BALA=[8%,190%]). Average velocity in the right hepatic vein and average area of the splenic vein were higher in cirrhosis (p=0.027/0.0039). Flow in the middle hepatic vein strongly correlated with Child-Pugh score (ρ=0.84, p=0.0238), while flow in the splenic vein (ρ=0.43,p=0.032), time-average (ρ=0.46,p=0.02) and peak velocity in the superior mesenteric vein (ρ=0.45,p=0.032), and peak velocity in the infrarenal IVC (ρ=0.39,p=0.032) positively correlated to an imaging-based portal hypertension score. Average area of the splenic vein predicted cirrhosis [p=0.019; AUC(95% CI)=0.87(0.71,1.00)] and clinically significant portal hypertension [p=0.042; AUC(95% CI)=0.78(0.57–0.99)]. Spiral 4D flow allows comprehensive assessment of abdominal vessels in one breath-hold, with substantial interobserver reproducibility, but variable test-retest repeatability. 4D flow may potentially reflect vascular changes due to cirrhosis and portal hypertension.
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影响因子：
25.7
作者：
Palaniyappan N;Cox E;Bradley C;Scott R;Austin A;O'Neill R;Ramjas G;Travis S;White H;Singh R;Thurley P;Guha IN;Francis S;Aithal GP
通讯作者：
Aithal GP
影响因子：
19.7
作者：
Gouya, Herve;Vignaux, Olivier;Legmann, Paul
通讯作者：
Legmann, Paul
影响因子：
13.5
作者：
Bedossa, P;Poynard, T
通讯作者：
Poynard, T
影响因子：
4.4
作者：
Frydrychowicz, A.;Landgraf, B. R.;Niespodzany, E.;Verma, R. W.;Roldan-Alzate, A.;Johnson, K. M.;Wieben, O.;Reeder, S. B.
通讯作者：
Reeder, S. B.
影响因子：
29.4
作者：
SABBA, C;WELTIN, GG;GROSZMANN, RJ
通讯作者：
GROSZMANN, RJ