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The invasive measurement of the hepatic venous pressure gradient is stillconsidered as the reference method to assess the severity of portalhypertension. Even though previous studies have shown that the liver stiffnessmeasured by elastography could predict portal hypertension in patients withchronic liver disease, the mechanisms behind remain today poorly understood.The main reason is that the liver stiffness is not specific to portalhypertension and is also influenced by concomitant pathologies, such ascirrhosis. Portal hypertension is also source of a vascular incidence, with asubstantial diversion of portal venous blood to the systemic circulation,bypassing the liver. This study focuses on this vascular effect of portalhypertension. We propose to generate and control the portal venous flow (toisolate the modifications in the portal venous flow as single effect of portalhypertension) in an anesthetized pig and then to quantify its implications onliver stiffness by an original combination of MRE and 4D-Flow MagneticResonance Imaging (MRI). A catheter balloon is progressively inflated in theportal vein and the peak flow, peak velocity magnitude and liver stiffness arequantified in a 1.5T MRI scanner (AREA, Siemens Healthcare, Erlangen, Germany).A strong correlation is observed between the portal peak velocity magnitude,the portal peak flow or the liver stiffness and the portal vein intraluminalobstruction. Moreover, the comparison of mechanical and flow parametershighlights a correlation with the possibility of identifying linearrelationships. These results give preliminary indications about how liverstiffness can be affected by portal venous flow and, by extension, byhypertension.

Magnetic Resonance Elastography and Portal Hypertension: Influence of the Portal Venous Flow on the Liver Stiffness