MRI assessment of altered dynamic changes in liver haemodynamics following a meal challenge in compensated cirrhosis
MRI assessment of altered dynamic changes in liver haemodynamics following a meal challenge in compensated cirrhosis
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DOI：
10.1186/s41747-018-0056-3
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发表时间：
2018-09-26
影响因子：
3.8
通讯作者：
Francis ST
中科院分区：
文献类型：
--
作者：
Cox EF;Palaniyappan N;Aithal GP;Guha IN;Francis ST
目的是使用磁共振成像（MRI）动态评估健康参与者和代偿性肝硬化（CC）肝病患者餐后肝脏和侧支血流、肝脏灌注和氧合的变化。我们评估了门静脉、肝动脉和奇静脉的血流（使用相位对比MRI）、肝脏灌注（使用动脉自旋标记）和血氧（使用横向弛豫时间[T2*]映射）。在10名健康受试者和10名CC患者中，在基线时和试验餐（440 mL，660 kcal）后20至65 min以6-7 min的间隔收集测量值。在健康受试者中，我们观察到餐后门静脉血流量较基线显著增加（+ 137 ± 26%（平均值±标准差），p < 0.001），同时肝动脉血流量较基线减少（− 30 ± 18%，p = 0.008），反映了肝动脉缓冲反应。在CC患者中，观察到门静脉血流量较低但仍显著增加（67 ± 50%，p = 0.014），没有明显的肝动脉缓冲反应。健康参与者显示餐后肝脏灌注显著增加（138 ± 75%，p < 0.001），而CC患者中未观察到。两组的肝脏T2* 均无变化。餐后肝脏灌注、氧合、肝脏和侧支循环的变化可以使用MRI无创测量。显示了健康参与者和CC患者之间的差异，这可能有助于对患者的肝硬化进行分层。
The aim was to use magnetic resonance imaging (MRI) to dynamically assess postprandial changes in hepatic and collateral blood flow, liver perfusion and oxygenation in healthy participants and patients with liver disease with compensated cirrhosis (CC). We evaluated blood flow in the portal vein, hepatic artery and azygos vein (using phase-contrast MRI), liver perfusion (using arterial spin labelling) and blood oxygenation (using transverse relaxation time [T2*] mapping). Measures were collected at baseline and at 6–7-min intervals from 20 to 65 min following a test meal (440 mL, 660 kcal) in 10 healthy participants and 10 patients with CC. In healthy participants, we observed a significant postprandial increase in portal vein flow from baseline (+ 137 ± 26% (mean ± standard deviation), p < 0.001) coupled with a reduction in hepatic artery flow from baseline (− 30 ± 18%, p = 0.008), reflecting the hepatic artery buffer response. In patients with CC, a lower but still significant increase in portal vein flow (67 ± 50%, p = 0.014) was observed, without a clear hepatic artery buffer response. Healthy participants showed a significant increase in postprandial liver perfusion (138 ± 75%, p < 0.001), not observed in patients with CC. There was no change in liver T2* for either group. Postprandial changes in liver perfusion, oxygenation and hepatic and collateral circulation can be measured noninvasively using MRI. Differences between healthy participants and patients with CC were shown, which may help stratify liver cirrhosis in patients.