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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
Author(s) -
Hyodo Ryota,
Takehara Yasuo,
Mizuno Takashi,
Ichikawa Kazushige,
Ishizu Yoji,
Sugiyama Masataka,
Naganawa Shinji
Publication year - 2021
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13616
Subject(s) - medicine , radiology , portosystemic shunt , magnetic resonance imaging , blood flow , embolization , shunt (medical) , hepatic encephalopathy , superior mesenteric vein , phase contrast microscopy , portal hypertension , portal vein , surgery , cirrhosis , physics , optics
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.