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Erschienen in: European Radiology 2/2017

18.05.2016 | Paediatric

4D flow MR imaging of the portal venous system: a feasibility study in children

verfasst von: Keyur Parekh, Michael Markl, Michael Rose, Susanne Schnell, Andrada Popescu, Cynthia K. Rigsby

Erschienen in: European Radiology | Ausgabe 2/2017

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Abstract

Objectives

To determine the feasibility of 4D flow MRI for visualization and quantification of the portal venous haemodynamics in children and young adults.

Methods

4D flow was performed in 28 paediatric patients (median age, 8.5 years; interquartile range, 5.2–16.5), 15 with non-operated native portal system and 13 with surgically created portal shunt. Image quality assessment for 3D flow visualization and flow pattern analyses was performed. Regional 4D flow peak velocity and net flow were compared with 2D-cine phase contrast MRI (2D-PC MR) in the post-surgical patients.

Results

Mean 3D flow visualization quality score was excellent (mean ± SD, 4.2 ± 0.9) with good inter-rater agreement (κ,0.67). Image quality in children aged >10 years was better than children ≤10 years (p < 0.05). Flow pattern was defined for portal, superior mesenteric, splenic veins and splenic artery in all patients. 4D flow and 2D-PC MR peak velocity and net flow were similar with good correlation (peak velocity: 4D flow 22.2 ± 9.1 cm/s and 2D-PC MR 25.2 ± 11.2 cm/s, p = 0.46; r = 0.92, p < 0.0001; net flow: 4D flow 9.5 ± 7.4 ml/s and 2D-PC MR 10.1 ± 7.3 ml/s, p = 0.65; r = 0.81, p = 0.0007).

Conclusions

4D flow MRI is feasible and holds promise for the comprehensive 3D visualization and quantification of portal venous flow dynamics in children and young adults.

Key Points

4D flow MRI is feasible in children and young adults.
4D flow MRI has the ability to non-invasively characterize portal haemodynamics.
Image quality of 4D flow MRI is better is older children.
4D flow MRI can accurately quantify portal flow compared to 2D-cine PC MRI.
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Literatur
1.
Zurück zum Zitat Markl M, Frydrychowicz A, Kozerke S, Hope M, Wieben O (2012) 4D flow MRI. J Magn Reson Imaging 36:1015–1036CrossRefPubMed Markl M, Frydrychowicz A, Kozerke S, Hope M, Wieben O (2012) 4D flow MRI. J Magn Reson Imaging 36:1015–1036CrossRefPubMed
2.
Zurück zum Zitat Frydrychowicz A, Landgraf BR, Niespodzany E et al (2011) Four-dimensional velocity mapping of the hepatic and splanchnic vasculature with radial sampling at 3 tesla: a feasibility study in portal hypertension. J Magn Reson Imaging 34:577–584CrossRefPubMedPubMedCentral Frydrychowicz A, Landgraf BR, Niespodzany E et al (2011) Four-dimensional velocity mapping of the hepatic and splanchnic vasculature with radial sampling at 3 tesla: a feasibility study in portal hypertension. J Magn Reson Imaging 34:577–584CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Stankovic Z, Frydrychowicz A, Csatari Z et al (2010) MR-based visualization and quantification of three-dimensional flow characteristics in the portal venous system. J Magn Reson Imaging 32:466–475CrossRefPubMed Stankovic Z, Frydrychowicz A, Csatari Z et al (2010) MR-based visualization and quantification of three-dimensional flow characteristics in the portal venous system. J Magn Reson Imaging 32:466–475CrossRefPubMed
4.
Zurück zum Zitat Stankovic Z, Csatari Z, Deibert P et al (2012) Normal and altered three-dimensional portal venous hemodynamics in patients with liver cirrhosis. Radiology 262:862–873CrossRefPubMed Stankovic Z, Csatari Z, Deibert P et al (2012) Normal and altered three-dimensional portal venous hemodynamics in patients with liver cirrhosis. Radiology 262:862–873CrossRefPubMed
5.
Zurück zum Zitat Roldan-Alzate A, Frydrychowicz A, Niespodzany E et al (2013) In vivo validation of 4D flow MRI for assessing the hemodynamics of portal hypertension. J Magn Reson Imaging 37:1100–1108CrossRefPubMed Roldan-Alzate A, Frydrychowicz A, Niespodzany E et al (2013) In vivo validation of 4D flow MRI for assessing the hemodynamics of portal hypertension. J Magn Reson Imaging 37:1100–1108CrossRefPubMed
6.
Zurück zum Zitat Stankovic Z, Csatari Z, Deibert P et al (2013) A feasibility study to evaluate splanchnic arterial and venous hemodynamics by flow-sensitive 4D MRI compared with Doppler ultrasound in patients with cirrhosis and controls. Eur J Gastroenterol Hepatol 25:669–675CrossRefPubMed Stankovic Z, Csatari Z, Deibert P et al (2013) A feasibility study to evaluate splanchnic arterial and venous hemodynamics by flow-sensitive 4D MRI compared with Doppler ultrasound in patients with cirrhosis and controls. Eur J Gastroenterol Hepatol 25:669–675CrossRefPubMed
7.
Zurück zum Zitat Stankovic Z, Jung B, Collins J et al (2014) Reproducibility study of four-dimensional flow MRI of arterial and portal venous liver hemodynamics: influence of spatio-temporal resolution. Magn Reson Med 72:477–484CrossRefPubMed Stankovic Z, Jung B, Collins J et al (2014) Reproducibility study of four-dimensional flow MRI of arterial and portal venous liver hemodynamics: influence of spatio-temporal resolution. Magn Reson Med 72:477–484CrossRefPubMed
8.
Zurück zum Zitat Stankovic Z, Rossle M, Euringer W et al (2015) Effect of TIPS placement on portal and splanchnic arterial blood flow in 4-dimensional flow MRI. Eur Radiol 25:2634–2640CrossRefPubMed Stankovic Z, Rossle M, Euringer W et al (2015) Effect of TIPS placement on portal and splanchnic arterial blood flow in 4-dimensional flow MRI. Eur Radiol 25:2634–2640CrossRefPubMed
9.
Zurück zum Zitat Ling SC (2012) Advances in the evaluation and management of children with portal hypertension. Semin Liver Dis 32:288–297PubMed Ling SC (2012) Advances in the evaluation and management of children with portal hypertension. Semin Liver Dis 32:288–297PubMed
10.
Zurück zum Zitat Shneider BL, Bosch J, de Franchis R et al (2012) Portal hypertension in children: expert pediatric opinion on the report of the Baveno v Consensus Workshop on Methodology of Diagnosis and Therapy in Portal Hypertension. Pediatr Transplant 16:426–437CrossRefPubMed Shneider BL, Bosch J, de Franchis R et al (2012) Portal hypertension in children: expert pediatric opinion on the report of the Baveno v Consensus Workshop on Methodology of Diagnosis and Therapy in Portal Hypertension. Pediatr Transplant 16:426–437CrossRefPubMed
11.
Zurück zum Zitat La Mura V, Nicolini A, Tosetti G, Primignani M (2015) Cirrhosis and portal hypertension: the importance of risk stratification, the role of hepatic venous pressure gradient measurement. World J Hepatol 7:688–695CrossRefPubMedPubMedCentral La Mura V, Nicolini A, Tosetti G, Primignani M (2015) Cirrhosis and portal hypertension: the importance of risk stratification, the role of hepatic venous pressure gradient measurement. World J Hepatol 7:688–695CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Lin LW, Duan XJ, Wang XY et al (2008) Color Doppler velocity profile and contrast-enhanced ultrasonography in assessment of liver cirrhosis. Hepatobiliary Pancreat Dis Int 7:34–39PubMed Lin LW, Duan XJ, Wang XY et al (2008) Color Doppler velocity profile and contrast-enhanced ultrasonography in assessment of liver cirrhosis. Hepatobiliary Pancreat Dis Int 7:34–39PubMed
14.
Zurück zum Zitat Robinson KA, Middleton WD, Al-Sukaiti R, Teefey SA, Dahiya N (2009) Doppler sonography of portal hypertension. Ultrasound Q 25:3–13CrossRefPubMed Robinson KA, Middleton WD, Al-Sukaiti R, Teefey SA, Dahiya N (2009) Doppler sonography of portal hypertension. Ultrasound Q 25:3–13CrossRefPubMed
15.
Zurück zum Zitat Dyvorne HA, Knight-Greenfield A, Besa C et al (2015) Quantification of hepatic blood flow using a high-resolution phase-contrast MRI sequence with compressed sensing acceleration. AJR Am J Roentgenol 204:510–518CrossRefPubMedPubMedCentral Dyvorne HA, Knight-Greenfield A, Besa C et al (2015) Quantification of hepatic blood flow using a high-resolution phase-contrast MRI sequence with compressed sensing acceleration. AJR Am J Roentgenol 204:510–518CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Gabbour M, Schnell S, Jarvis K, Robinson JD, Markl M, Rigsby CK (2015) 4-D flow magnetic resonance imaging: blood flow quantification compared to 2-D phase-contrast magnetic resonance imaging and Doppler echocardiography. Pediatr Radiol 45:804–813CrossRefPubMed Gabbour M, Schnell S, Jarvis K, Robinson JD, Markl M, Rigsby CK (2015) 4-D flow magnetic resonance imaging: blood flow quantification compared to 2-D phase-contrast magnetic resonance imaging and Doppler echocardiography. Pediatr Radiol 45:804–813CrossRefPubMed
17.
Zurück zum Zitat Krishnamurthy R, Cheong B, Muthupillai R (2014) Tools for cardiovascular magnetic resonance imaging. Cardiovasc Diagn Ther 4:104–125PubMedPubMedCentral Krishnamurthy R, Cheong B, Muthupillai R (2014) Tools for cardiovascular magnetic resonance imaging. Cardiovasc Diagn Ther 4:104–125PubMedPubMedCentral
18.
Zurück zum Zitat Roldan-Alzate A, Frydrychowicz A, Said A et al (2015) Impaired regulation of portal venous flow in response to a meal challenge as quantified by 4D flow MRI. J Magn Reson Imaging 42:1009–1017CrossRefPubMedPubMedCentral Roldan-Alzate A, Frydrychowicz A, Said A et al (2015) Impaired regulation of portal venous flow in response to a meal challenge as quantified by 4D flow MRI. J Magn Reson Imaging 42:1009–1017CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Bernstein MA, Zhou XJ, Polzin JA et al (1998) Concomitant gradient terms in phase contrast MR: analysis and correction. Magn Reson Med 39:300–308CrossRefPubMed Bernstein MA, Zhou XJ, Polzin JA et al (1998) Concomitant gradient terms in phase contrast MR: analysis and correction. Magn Reson Med 39:300–308CrossRefPubMed
20.
Zurück zum Zitat Walker PG, Cranney GB, Scheidegger MB, Waseleski G, Pohost GM, Yoganathan AP (1993) Semiautomated method for noise reduction and background phase error correction in MR phase velocity data. J Magn Reson Imaging 3:521–530CrossRefPubMed Walker PG, Cranney GB, Scheidegger MB, Waseleski G, Pohost GM, Yoganathan AP (1993) Semiautomated method for noise reduction and background phase error correction in MR phase velocity data. J Magn Reson Imaging 3:521–530CrossRefPubMed
21.
Zurück zum Zitat Bock J, Frydrychowicz A, Stalder AF et al (2010) 4D phase contrast MRI at 3 T: effect of standard and blood-pool contrast agents on SNR, PC-MRA, and blood flow visualization. Magn Reson Med 63:330–338CrossRefPubMed Bock J, Frydrychowicz A, Stalder AF et al (2010) 4D phase contrast MRI at 3 T: effect of standard and blood-pool contrast agents on SNR, PC-MRA, and blood flow visualization. Magn Reson Med 63:330–338CrossRefPubMed
22.
Zurück zum Zitat Schnell S, Entezari P, Mahadewia RJ et al (2015) Improved semiautomated 4D flow MRI analysis in the aorta in patients with congenital aortic valve anomalies versus tricuspid aortic valves. J Comput Assist Tomogr. doi:10.1097/RCT.0000000000000312 Schnell S, Entezari P, Mahadewia RJ et al (2015) Improved semiautomated 4D flow MRI analysis in the aorta in patients with congenital aortic valve anomalies versus tricuspid aortic valves. J Comput Assist Tomogr. doi:10.​1097/​RCT.​0000000000000312​
23.
Zurück zum Zitat Buonocore MH (1998) Visualizing blood flow patterns using streamlines, arrows, and particle paths. Magn Reson Med 40:210–226CrossRefPubMed Buonocore MH (1998) Visualizing blood flow patterns using streamlines, arrows, and particle paths. Magn Reson Med 40:210–226CrossRefPubMed
24.
Zurück zum Zitat Geiger J, Hirtler D, Burk J et al (2014) Postoperative pulmonary and aortic 3D haemodynamics in patients after repair of transposition of the great arteries. Eur Radiol 24:200–208CrossRefPubMed Geiger J, Hirtler D, Burk J et al (2014) Postoperative pulmonary and aortic 3D haemodynamics in patients after repair of transposition of the great arteries. Eur Radiol 24:200–208CrossRefPubMed
25.
Zurück zum Zitat Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed
26.
Zurück zum Zitat Schnell S, Markl M, Entezari P et al (2014) k-t GRAPPA accelerated four-dimensional flow MRI in the aorta: effect on scan time, image quality, and quantification of flow and wall shear stress. Magn Reson Med 72:522–533CrossRefPubMed Schnell S, Markl M, Entezari P et al (2014) k-t GRAPPA accelerated four-dimensional flow MRI in the aorta: effect on scan time, image quality, and quantification of flow and wall shear stress. Magn Reson Med 72:522–533CrossRefPubMed
27.
Zurück zum Zitat Jung B, Honal M, Ullmann P, Hennig J, Markl M (2008) Highly k-t-space-accelerated phase-contrast MRI. Magn Reson Med 60:1169–1177CrossRefPubMed Jung B, Honal M, Ullmann P, Hennig J, Markl M (2008) Highly k-t-space-accelerated phase-contrast MRI. Magn Reson Med 60:1169–1177CrossRefPubMed
28.
Zurück zum Zitat Frydrychowicz A, Wieben O, Niespodzany E, Reeder SB, Johnson KM, Francois CJ (2013) Quantification of thoracic blood flow using volumetric magnetic resonance imaging with radial velocity encoding: in vivo validation. Investig Radiol 48:819–825CrossRef Frydrychowicz A, Wieben O, Niespodzany E, Reeder SB, Johnson KM, Francois CJ (2013) Quantification of thoracic blood flow using volumetric magnetic resonance imaging with radial velocity encoding: in vivo validation. Investig Radiol 48:819–825CrossRef
29.
Zurück zum Zitat Gu T, Korosec FR, Block WF et al (2005) PC VIPR: a high-speed 3D phase-contrast method for flow quantification and high-resolution angiography. AJNR Am J Neuroradiol 26:743–749PubMed Gu T, Korosec FR, Block WF et al (2005) PC VIPR: a high-speed 3D phase-contrast method for flow quantification and high-resolution angiography. AJNR Am J Neuroradiol 26:743–749PubMed
30.
Zurück zum Zitat Cheng JY, Hanneman K, Zhang T et al (2015) Comprehensive motion-compensated highly accelerated 4D flow MRI with ferumoxytol enhancement for pediatric congenital heart disease. J Magn Reson Imaging. doi:10.1002/jmri.25106 PubMedCentral Cheng JY, Hanneman K, Zhang T et al (2015) Comprehensive motion-compensated highly accelerated 4D flow MRI with ferumoxytol enhancement for pediatric congenital heart disease. J Magn Reson Imaging. doi:10.​1002/​jmri.​25106 PubMedCentral
31.
Zurück zum Zitat Hsiao A, Lustig M, Alley MT et al (2012) Rapid pediatric cardiac assessment of flow and ventricular volume with compressed sensing parallel imaging volumetric cine phase-contrast MRI. AJR Am J Roentgenol 198:W250–W259CrossRefPubMedPubMedCentral Hsiao A, Lustig M, Alley MT et al (2012) Rapid pediatric cardiac assessment of flow and ventricular volume with compressed sensing parallel imaging volumetric cine phase-contrast MRI. AJR Am J Roentgenol 198:W250–W259CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Petersson S, Dyverfeldt P, Sigfridsson A, Lantz J, Carlhall CJ, Ebbers T (2016) Quantification of turbulence and velocity in stenotic flow using spiral three-dimensional phase-contrast MRI. Magn Reson Med 75:1249–1255CrossRefPubMed Petersson S, Dyverfeldt P, Sigfridsson A, Lantz J, Carlhall CJ, Ebbers T (2016) Quantification of turbulence and velocity in stenotic flow using spiral three-dimensional phase-contrast MRI. Magn Reson Med 75:1249–1255CrossRefPubMed
33.
Zurück zum Zitat Dyvorne H, Knight-Greenfield A, Jajamovich G et al (2015) Abdominal 4D flow MR imaging in a breath hold: combination of spiral sampling and dynamic compressed sensing for highly accelerated acquisition. Radiology 275:245–254CrossRefPubMed Dyvorne H, Knight-Greenfield A, Jajamovich G et al (2015) Abdominal 4D flow MR imaging in a breath hold: combination of spiral sampling and dynamic compressed sensing for highly accelerated acquisition. Radiology 275:245–254CrossRefPubMed
34.
Zurück zum Zitat Singh AK, Nachiappan AC, Verma HA et al (2010) Postoperative imaging in liver transplantation: what radiologists should know. Radiographics 30:339–351CrossRefPubMed Singh AK, Nachiappan AC, Verma HA et al (2010) Postoperative imaging in liver transplantation: what radiologists should know. Radiographics 30:339–351CrossRefPubMed
Metadaten
Titel
4D flow MR imaging of the portal venous system: a feasibility study in children
verfasst von
Keyur Parekh
Michael Markl
Michael Rose
Susanne Schnell
Andrada Popescu
Cynthia K. Rigsby
Publikationsdatum
18.05.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 2/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4396-1

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