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

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 tomograp...

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Bibliographic Details
Published in:Hepatology research 2021-03, Vol.51 (3), p.343-349
Main Authors: Hyodo, Ryota, Takehara, Yasuo, Mizuno, Takashi, Ichikawa, Kazushige, Ishizu, Yoji, Sugiyama, Masataka, Naganawa, Shinji
Format: Article
Language:English
Subjects:
4D‐flow MRI
Blood flow
Computed tomography
Doppler effect
Embolization
Hepatic encephalopathy
Magnetic resonance imaging
portal hemodynamics
Portal vein
portosystemic shunts
shunt embolization
Shunts
Ultrasound
Veins & arteries
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Summary: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.
ISSN:1386-6346
1872-034X
DOI:10.1111/hepr.13616