title: A non-invasive magnetic resonance imaging-based model predicts portal venous pressure.
abstract: OBJECTIVE
  To establish a non-invasive model for the assessment of portal venous pressure (PVP) based on the magnetic resonance (MR) parameters.
  
  
  METHODS
  In this prospective study, contrast-enhanced magnetic resonance imaging (MRI) scan was performed in 109 patients indicated for upper abdominal surgeries after their written consents were obtained, and intraoperative PVP measurements were completed in 92 patients. Altogether 17 patients were excluded for not undergoing surgery or unsuccessful catheterization. A linear model was constructed for estimating PVP levels in 56 patients and further validation was conducted in the other 36 patients.
  
  
  RESULTS
  The PVP levels were significantly correlated with MR parameters, including splenic volume (SV), splenic venous diameter (SVD), liver/splenic volume ratio, portal venous diameter, hepatic diameter, portal venous cross-sectional area, ascites, varices and arterial portal shunts. A linear model was established as follows: PVP (mmHg) = 2.529 + 1.572 × SVD (mm) + 0.231 × SV/body mass index (× 10(4) cm(5) /kg) + 3.44 × aspartate aminotransferase-to-platelet ratio index. This model showed excellent accuracy in the detection of portal hypertension, with the area under the receiver operating characteristic curve (AUROC) of 0.945 (95% CI 0.867-1.000), with the sensitivity and specificity of 91.7% and 93.7%, respectively. The agreement analysis revealed that the predictive value using this formula closely reflected the patients' actual PVP level. Moreover, the validation confirmed the accuracy of this model for the assessment of portal hypertension [AUROC 0.935 (95% CI 0.856-1.000)].
  
  
  CONCLUSIONS
  The MRI-based formula has great potential for detecting portal hypertension. As a non-invasive measurement, it may be clinically accepted for the replacement of invasive modalities after further refinement.
authors: Department of Gastroenterology.
authors: Qian Wen
authors: QW
authors: Zhang
authors: Department of General Surgery.
authors: Yi
authors: Y
authors: Wang
authors: Department of Gastroenterology.
authors: Jian
authors: J
authors: Wang
authors: Department of Radiology, Changzheng Hospital, Second Military Medical University.
authors: Hong Bo
authors: HB
authors: Zhao
authors: Department of Radiology, Changzheng Hospital, Second Military Medical University.
authors: Hong
authors: H
authors: Yu
authors: Department of Radiology, Changzheng Hospital, Second Military Medical University.
authors: Shi Yuan
authors: SY
authors: Liu
authors: Department of Gastroenterology.
authors: Xin
authors: X
authors: Zeng
authors: Department of Health Statistics, Second Military Medical University.
authors: Qi
authors: Q
authors: Chen
authors: Department of General Surgery.
authors: Zhi Qian
authors: ZQ
authors: Hu
authors: Organ Transplantation Center.
authors: Wen Yuan
authors: WY
authors: Guo
authors: Organ Transplantation Center.
authors: Zhi Ren
authors: ZR
authors: Fu
authors: Organ Transplantation Center.
authors: Guo Shan
authors: GS
authors: Ding
authors: Xue Yin
authors: XY
authors: Shi
authors: Department of Gastroenterology.
authors: Wei Fen
authors: WF
authors: Xie
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D015588:Observer Variation; D017082:Portal Pressure; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013154:Spleen / Q000473:pathology; D013162:Splenic Vein / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D003287:Contrast Media
keywords: aspartate aminotransferase-to-platelet ratio index; imaging modality; magnetic resonance imaging; portal hypertension; splenic venous diameter; splenic volume