Impaired regulation of portal venous flow in response to a meal challenge as quantified by 4D flow MRI
Purpose Portal and mesenteric hemodynamics is greatly altered in portal hypertension patients. This study utilizes 4D flow magnetic resonance imaging (MRI) to visualize and quantify changes in abdominal hemodynamics in patients with portal hypertension undergoing meal challenge. Materials and Method...
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| Published in | Journal of magnetic resonance imaging Vol. 42; no. 4; pp. 1009 - 1017 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Blackwell Publishing Ltd
01.10.2015
Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1053-1807 1522-2586 1522-2586 |
| DOI | 10.1002/jmri.24886 |
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| Abstract | Purpose
Portal and mesenteric hemodynamics is greatly altered in portal hypertension patients. This study utilizes 4D flow magnetic resonance imaging (MRI) to visualize and quantify changes in abdominal hemodynamics in patients with portal hypertension undergoing meal challenge.
Materials and Methods
Twelve portal hypertension patients and six healthy subjects participated in the study. Baseline MRI was acquired after 5 hours of fasting. Postmeal MRI was obtained 20 minutes after subjects ingested EnSure Plus (574 mL). Imaging was performed at 3T using 4D flow MRI with an undersampled radial acquisition. Flow measurements were performed blinded to subject status (fasting/meal). Flow values for each vessel were compared before and after the meal challenge using paired Student's t‐tests (P < 0.05).
Results
After meal challenge, significant increases in blood flow were observed in supraceliac aorta, portal vein, superior mesenteric vein, and artery in both groups (P < 0.05). In patients, hepatic artery (P = 0.001) and splenic vein (P = 0.045) flow decreased while azygos vein flow (P = 0.002) increased.
Conclusion
Portal venous flow regulation to adjust the increasing mesenteric venous flow after a meal challenge may be impaired in patients with cirrhosis. The ability to comprehensively quantify the hemodynamic response of the abdominal vasculature to a meal challenge using 4D flow MRI reveals the potential of this technique to noninvasively characterize portal hypertension hemodynamics. J. Magn. Reson. Imaging 2015;42:1009–1017. |
|---|---|
| AbstractList | Purpose
Portal and mesenteric hemodynamics is greatly altered in portal hypertension patients. This study utilizes 4D flow magnetic resonance imaging (MRI) to visualize and quantify changes in abdominal hemodynamics in patients with portal hypertension undergoing meal challenge.
Materials and Methods
Twelve portal hypertension patients and six healthy subjects participated in the study. Baseline MRI was acquired after 5 hours of fasting. Postmeal MRI was obtained 20 minutes after subjects ingested EnSure Plus (574 mL). Imaging was performed at 3T using 4D flow MRI with an undersampled radial acquisition. Flow measurements were performed blinded to subject status (fasting/meal). Flow values for each vessel were compared before and after the meal challenge using paired Student's t‐tests (P < 0.05).
Results
After meal challenge, significant increases in blood flow were observed in supraceliac aorta, portal vein, superior mesenteric vein, and artery in both groups (P < 0.05). In patients, hepatic artery (P = 0.001) and splenic vein (P = 0.045) flow decreased while azygos vein flow (P = 0.002) increased.
Conclusion
Portal venous flow regulation to adjust the increasing mesenteric venous flow after a meal challenge may be impaired in patients with cirrhosis. The ability to comprehensively quantify the hemodynamic response of the abdominal vasculature to a meal challenge using 4D flow MRI reveals the potential of this technique to noninvasively characterize portal hypertension hemodynamics. J. Magn. Reson. Imaging 2015;42:1009–1017. Portal and mesenteric hemodynamics is greatly altered in portal hypertension patients. This study utilizes 4D flow magnetic resonance imaging (MRI) to visualize and quantify changes in abdominal hemodynamics in patients with portal hypertension undergoing meal challenge.PURPOSEPortal and mesenteric hemodynamics is greatly altered in portal hypertension patients. This study utilizes 4D flow magnetic resonance imaging (MRI) to visualize and quantify changes in abdominal hemodynamics in patients with portal hypertension undergoing meal challenge.Twelve portal hypertension patients and six healthy subjects participated in the study. Baseline MRI was acquired after 5 hours of fasting. Postmeal MRI was obtained 20 minutes after subjects ingested EnSure Plus (574 mL). Imaging was performed at 3T using 4D flow MRI with an undersampled radial acquisition. Flow measurements were performed blinded to subject status (fasting/meal). Flow values for each vessel were compared before and after the meal challenge using paired Student's t-tests (P < 0.05).MATERIALS AND METHODSTwelve portal hypertension patients and six healthy subjects participated in the study. Baseline MRI was acquired after 5 hours of fasting. Postmeal MRI was obtained 20 minutes after subjects ingested EnSure Plus (574 mL). Imaging was performed at 3T using 4D flow MRI with an undersampled radial acquisition. Flow measurements were performed blinded to subject status (fasting/meal). Flow values for each vessel were compared before and after the meal challenge using paired Student's t-tests (P < 0.05).After meal challenge, significant increases in blood flow were observed in supraceliac aorta, portal vein, superior mesenteric vein, and artery in both groups (P < 0.05). In patients, hepatic artery (P = 0.001) and splenic vein (P = 0.045) flow decreased while azygos vein flow (P = 0.002) increased.RESULTSAfter meal challenge, significant increases in blood flow were observed in supraceliac aorta, portal vein, superior mesenteric vein, and artery in both groups (P < 0.05). In patients, hepatic artery (P = 0.001) and splenic vein (P = 0.045) flow decreased while azygos vein flow (P = 0.002) increased.Portal venous flow regulation to adjust the increasing mesenteric venous flow after a meal challenge may be impaired in patients with cirrhosis. The ability to comprehensively quantify the hemodynamic response of the abdominal vasculature to a meal challenge using 4D flow MRI reveals the potential of this technique to noninvasively characterize portal hypertension hemodynamics.CONCLUSIONPortal venous flow regulation to adjust the increasing mesenteric venous flow after a meal challenge may be impaired in patients with cirrhosis. The ability to comprehensively quantify the hemodynamic response of the abdominal vasculature to a meal challenge using 4D flow MRI reveals the potential of this technique to noninvasively characterize portal hypertension hemodynamics. Purpose Portal and mesenteric hemodynamics is greatly altered in portal hypertension patients. This study utilizes 4D flow magnetic resonance imaging (MRI) to visualize and quantify changes in abdominal hemodynamics in patients with portal hypertension undergoing meal challenge. Materials and Methods Twelve portal hypertension patients and six healthy subjects participated in the study. Baseline MRI was acquired after 5 hours of fasting. Postmeal MRI was obtained 20 minutes after subjects ingested EnSure Plus (574 mL). Imaging was performed at 3T using 4D flow MRI with an undersampled radial acquisition. Flow measurements were performed blinded to subject status (fasting/meal). Flow values for each vessel were compared before and after the meal challenge using paired Student's t-tests (P < 0.05). Results After meal challenge, significant increases in blood flow were observed in supraceliac aorta, portal vein, superior mesenteric vein, and artery in both groups (P < 0.05). In patients, hepatic artery (P=0.001) and splenic vein (P=0.045) flow decreased while azygos vein flow (P=0.002) increased. Conclusion Portal venous flow regulation to adjust the increasing mesenteric venous flow after a meal challenge may be impaired in patients with cirrhosis. The ability to comprehensively quantify the hemodynamic response of the abdominal vasculature to a meal challenge using 4D flow MRI reveals the potential of this technique to noninvasively characterize portal hypertension hemodynamics. J. Magn. Reson. Imaging 2015;42:1009-1017. Portal and mesenteric hemodynamics is greatly altered in portal hypertension patients. This study utilizes 4D flow magnetic resonance imaging (MRI) to visualize and quantify changes in abdominal hemodynamics in patients with portal hypertension undergoing meal challenge. Twelve portal hypertension patients and six healthy subjects participated in the study. Baseline MRI was acquired after 5 hours of fasting. Postmeal MRI was obtained 20 minutes after subjects ingested EnSure Plus (574 mL). Imaging was performed at 3T using 4D flow MRI with an undersampled radial acquisition. Flow measurements were performed blinded to subject status (fasting/meal). Flow values for each vessel were compared before and after the meal challenge using paired Student's t-tests (P < 0.05). After meal challenge, significant increases in blood flow were observed in supraceliac aorta, portal vein, superior mesenteric vein, and artery in both groups (P < 0.05). In patients, hepatic artery (P = 0.001) and splenic vein (P = 0.045) flow decreased while azygos vein flow (P = 0.002) increased. Portal venous flow regulation to adjust the increasing mesenteric venous flow after a meal challenge may be impaired in patients with cirrhosis. The ability to comprehensively quantify the hemodynamic response of the abdominal vasculature to a meal challenge using 4D flow MRI reveals the potential of this technique to noninvasively characterize portal hypertension hemodynamics. |
| Author | Reeder, Scott B. Frydrychowicz, Alex Roldán-Alzate, Alejandro Said, Adnan Johnson, Kevin M. Francois, Christopher J. Wieben, Oliver |
| AuthorAffiliation | 5 Department of Radiology Universitätsklinikum Schleswig-Holstein, Lu beck, Germany 1 Department of Radiology University of Wisconsin, Madison, WI 4 Department of Biomedical Engineering University of Wisconsin, Madison, WI 3 Department of Medical Physics University of Wisconsin, Madison, WI 2 Department of Medicine, Gastroenterology and Hepatology University of Wisconsin, Madison, WI |
| AuthorAffiliation_xml | – name: 1 Department of Radiology University of Wisconsin, Madison, WI – name: 3 Department of Medical Physics University of Wisconsin, Madison, WI – name: 5 Department of Radiology Universitätsklinikum Schleswig-Holstein, Lu beck, Germany – name: 2 Department of Medicine, Gastroenterology and Hepatology University of Wisconsin, Madison, WI – name: 4 Department of Biomedical Engineering University of Wisconsin, Madison, WI |
| Author_xml | – sequence: 1 givenname: Alejandro surname: Roldán-Alzate fullname: Roldán-Alzate, Alejandro email: roldan@wisc.edu organization: Department of Radiology, University of Wisconsin, Wisconsin, Madison, USA – sequence: 2 givenname: Alex surname: Frydrychowicz fullname: Frydrychowicz, Alex organization: Department of Radiology, Universitätsklinikum Schleswig-Holstein, Lubeck, Germany – sequence: 3 givenname: Adnan surname: Said fullname: Said, Adnan organization: Department of Medicine, Gastroenterology and Hepatology, University of Wisconsin, Wisconsin, Madison, USA – sequence: 4 givenname: Kevin M. surname: Johnson fullname: Johnson, Kevin M. organization: Department of Medical Physics, University of Wisconsin, Wisconsin, Madison, USA – sequence: 5 givenname: Christopher J. surname: Francois fullname: Francois, Christopher J. organization: Department of Radiology, University of Wisconsin, Wisconsin, Madison, USA – sequence: 6 givenname: Oliver surname: Wieben fullname: Wieben, Oliver organization: Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA – sequence: 7 givenname: Scott B. surname: Reeder fullname: Reeder, Scott B. organization: Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25772828$$D View this record in MEDLINE/PubMed |
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Portal and mesenteric hemodynamics is greatly altered in portal hypertension patients. This study utilizes 4D flow magnetic resonance imaging (MRI) to... Portal and mesenteric hemodynamics is greatly altered in portal hypertension patients. This study utilizes 4D flow magnetic resonance imaging (MRI) to... Purpose Portal and mesenteric hemodynamics is greatly altered in portal hypertension patients. This study utilizes 4D flow magnetic resonance imaging (MRI) to... |
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| SubjectTerms | Adult Aged Blood Flow Velocity Eating Female hepatic hemodynamics Humans Hypertension Hypertension, Portal - pathology Hypertension, Portal - physiopathology Imaging, Three-Dimensional - methods Magnetic Resonance Angiography - methods Magnetic resonance imaging Male meal challenge Middle Aged NMR noninvasive Nuclear magnetic resonance Observer Variation portal hypertension Portal Vein - physiopathology Reproducibility of Results Respiratory-Gated Imaging Techniques - methods Sensitivity and Specificity Spleen Veins & arteries |
| Title | Impaired regulation of portal venous flow in response to a meal challenge as quantified by 4D flow MRI |
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