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Abstract #0742

4D flow MRI of splanchnic vasculature for diagnosis of severe portal hypertension and prediction of outcomes

Octavia Bane1,2, Amine Geahchan1, Daniel Stocker3, Ghadi Abboud1, Paul Kennedy1, Himanshu Sharma1, Stefanie Hectors1, Swan Thung4, Ning Jin5, Aaron Fischman1, Michael Markl6, Scott Reeder7, Thomas Schiano8, and Bachir Taouli1,2
1Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, 2BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States, 3Radiology, University Hospital Zurich, Zurich, Switzerland, 4Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, 5Siemens Healthineers, Solon, OH, United States, 6Biomedical Engineering, Northwestern University, Chicago, IL, United States, 7University of Wisconsin, Madison, WI, United States, 8Recanati-Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States

Synopsis

Keywords: Velocity/Flow, Flow, portal hypertension, 4D flow MRI, liver decompensation

Motivation: Non-invasive detection of severe portal hypertension [PH; hepatic venous pressure gradient (HVPG)≥12 mmHg] is important to prevent decompensation and death in patients with chronic liver disease.

Goal(s): We assess the diagnostic performance of hemodynamic parameters measured with 4D flow MRI in the splanchnic vasculature for diagnosis of severe PH and prediction of liver decompensation.

Approach: In our prospective, single-center study, 56 patients with chronic liver disease had 4D flow MRI within a month of invasive HVPG measurement.

Results: Splanchnic hemodynamic measurements by 4D flow MRI identified patients with severe portal hypertension with excellent diagnostic performance, and predicted liver decompensation with good diagnostic performance.

Impact: 4D flow MRI diagnoses severe portal hypertension with excellent performance, and predicts hepatic decompensation with equivalent performance to HVPG, making it suitable for integration into surveillance MRI protocols for patients with liver cirrhosis.

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Keywords