title: 4D flow MR imaging of the portal venous system: a feasibility study in children.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Department of Medical Imaging, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Chicago, IL, 60611, USA. 23.keyurparekh@gmail.com.|Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 23.keyurparekh@gmail.com.
authors.forename: Keyur
authors.initials: K
authors.lastname: Parekh
authors.affiliation: Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.|Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Markl
authors.affiliation: Department of Medical Imaging, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Chicago, IL, 60611, USA.|Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Rose
authors.affiliation: Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Susanne
authors.initials: S
authors.lastname: Schnell
authors.affiliation: Department of Medical Imaging, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Chicago, IL, 60611, USA.|Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Andrada
authors.initials: A
authors.lastname: Popescu
authors.affiliation: Department of Medical Imaging, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Chicago, IL, 60611, USA.|Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Rigsby
mesh_terms: D000293:Adolescent; D001783:Blood Flow Velocity; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging*; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011170:Portasystemic Shunt, Surgical; D011446:Prospective Studies; D013157:Splenic Artery / Q000000981:diagnostic imaging*; D013162:Splenic Vein / Q000000981:diagnostic imaging*
keywords: 4D flow MRI; Children; Magnetic resonance imaging; Phase contrast MRI; Portal vein