MR-based visualization and quantification of three-dimensional flow characteristics in the portal venous system.
OBJECTIVE
To evaluate the feasibility of time-resolved flow-sensitive MRI for the three-dimensional (3D) visualization and quantification of normal and pathological portal venous (PV) hemodynamics.


METHODS
Portal venous hemodynamics were evaluated in 18 healthy volunteers and 5 patients with liver cirrhosis. ECG- and adaptive respiratory navigator gated flow-sensitive 4D MRI (time-resolved 3D MRI with three-directional velocity encoding) was performed on a 3 Tesla MR system (TRIO, Siemens, Germany). Qualitative flow analysis was achieved using 3D streamlines and time-resolved particle traces originating from seven emitter planes precisely placed at anatomical landmarks in the PV system. Quantitative analysis included retrospective extraction of regional peak and mean velocities and vessel area. Results were compared with standard 2D flow-sensitive MRI and to the reference standard Doppler ultrasound.


RESULTS
Qualitative flow analysis was successfully used in the entire PV system. Venous hemodynamics in all major branches in 17 of 18 volunteers and 3 of 5 patients were reliably depicted with good interobserver agreement (kappa = 0.62). Quantitative analysis revealed no significant differences and moderate agreement for peak velocities between 3D MR and 2D MRI (r = 0.46) and Doppler ultrasound (US) (r = 0.35) and for mean velocities between 3D and 2D MRI (r = 0.41). The PV area was significantly (P < 0.01) higher in 3D and 2D MRI compared with US.


CONCLUSIONS
We successfully applied 3D MR velocity mapping in the PV system, providing a detailed qualitative and quantitative analysis of normal and pathological hemodynamics.
Stankovic
Zoran
Z
Department of Diagnostic Radiology and Medical Physics, University Hospital Freiburg, Freiburg, Germany. zoran.stankovic@uniklinik-freiburg.de
Frydrychowicz
Alex
A
Csatari
Zoltan
Z
Panther
Elisabeth
E
Deibert
Peter
P
Euringer
Wulf
W
Kreisel
Wolfgang
W
Russe
Maximilian
M
Bauer
Simon
S
Langer
Mathias
M
Markl
Michael
M
D000328:Adult; D000368:Aged; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008103:Liver Cirrhosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology*; D012119:Respiration; D018608:Ultrasonography, Doppler / Q000379:methods