Portal hypertension in patients with cirrhosis: indirect assessment of hepatic venous pressure gradient by measuring azygos flow with 2D-cine phase-contrast magnetic resonance imaging.
Objectives: To measure azygos, portal and aortic flow by two-dimensional cine phase-contrast magnetic resonance imaging (2D-cine PC MRI), and to compare the MRI values to hepatic venous pressure gradient (HVPG) measurements, in patients with cirrhosis.Methods: Sixty-nine patients with cirrhosis were...
| Publicado en: | European Radiology Vol. 26; no. 7; pp. 1981 - 1991 |
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| Autores principales: | , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Jul2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=116101237&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 116101237 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Jul2016 vid: 26 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 116101237 116101237 NLM26373753 10.1007/s00330-015-3991-x NLM26373753 116101237 ppf: 1981 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Portal hypertension in patients with cirrhosis: indirect assessment of hepatic venous pressure gradient by measuring azygos flow with 2D-cine phase-contrast magnetic resonance imaging. aug: au: Gouya, Hervé Grabar, Sophie Vignaux, Olivier Saade, Anastasia Pol, Stanislas Legmann, Paul Sogni, Philippe Gouya, Hervé affil: Department of Radiology, Hôpital Cochin and Paris-Descartes University, Assistance Publique-Hôpitaux de Paris, 27 rue du faubourg St Jacques 75014 Paris France sug: subj: Liver Cirrhosis Azygos Vein Physiopathology Hepatic Veins Physiology Hypertension, Portal Liver Blood Supply Magnetic Resonance Imaging Methods Blood Circulation Physiology Adult Hypertension, Portal Physiopathology Aorta Physiopathology Portal Pressure Physiology Venous Pressure Physiology Pharmacokinetics ROC Curve Magnetic Resonance Imaging Linear Regression Prospective Studies Male Microscopy Methods Liver Cirrhosis Physiopathology Regression Middle Age Female Aged Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Objectives: To measure azygos, portal and aortic flow by two-dimensional cine phase-contrast magnetic resonance imaging (2D-cine PC MRI), and to compare the MRI values to hepatic venous pressure gradient (HVPG) measurements, in patients with cirrhosis.Methods: Sixty-nine patients with cirrhosis were prospectively included. All patients underwent HVPG measurements, upper gastrointestinal endoscopy and 2D-cine PC MRI measurements of azygos, portal and aortic blood flow. Univariate and multivariate regression analyses were used to evaluate the correlation between the blood flow and HVPG. The performance of 2D-cine PC MRI to diagnose severe portal hypertension (HVPG ≥ 16 mmHg) was determined by receiver operating characteristic curve (ROC) analysis, and area under the curves (AUC) were compared.Results: Azygos and aortic flow values were associated with HVPG in univariate linear regression model. Azygos flow (p < 10(-3)), aortic flow (p = 0.001), age (p = 0.001) and presence of varices (p < 10(-3)) were independently associated with HVPG. Azygos flow (AUC = 0.96 (95 % CI [0.91-1.00]) had significantly higher AUC than aortic (AUC = 0.64 (95 % CI [0.51-0.77]) or portal blood flow (AUC = 0.40 (95 % CI [0.25-0.54]).Conclusions: 2D-cine PC MRI is a promising technique to evaluate significant portal hypertension in patients with cirrhosis.Key Points: • Noninvasive HVPG assessment can be performed with MRI azygos flow. • Azygos MRI flow is an easy-to-measure marker to detect significant portal hypertension. • MRI flow is more specific that varice grade to detect portal hypertension. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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