Evaluation of 4D Flow MRI-Derived Relative Residence Time as a Marker for Cirrhosis Associated Portal Vein Thrombosis

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-03-15 DOI:10.1002/jmri.29357

Ryota Hyodo MD, PhD, Yasuo Takehara MD, PhD, Yoji Ishizu MD, PhD, Kazuki Nishida MD, PhD, Takashi Mizuno MSc, Kazushige Ichikawa MSc, Ryota Horiguchi MD, PhD, Nobuhiko Kurata MD, PhD, Yasuhiro Ogura MD, PhD, Shinya Yokoyama MD, PhD, Shinji Naganawa MD, PhD, Ning Jin PhD, Yoshito Ichiba RT

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Abstract

Background

Portal vein thrombosis (PVT) is thought to arise from stagnant blood flow, yet conclusive evidence is lacking. Relative residence time (RRT) assessed using 4D Flow MRI may offer insight into portal flow stagnation.

Purpose

To explore the relationship between RRT values and the presence of PVT in cirrhotic participants.

Study Type

Prospective.

Population

Forty-eight participants with liver cirrhosis (27 males, median age 67 years [IQR: 57–73]) and 20 healthy control participants (12 males, median age 45 years [IQR: 40–54]).

Field Strength/Sequence

3 T/4D Flow MRI.

Assessment

Laboratory (liver and kidney function test results and platelet count) and clinical data (presence of tumors and other imaging findings), and portal hemodynamics derived from 4D Flow MRI (spatiotemporally averaged RRT [RRT-mean], flow velocity, and flow rate) were analyzed.

Statistical Tests

We used multivariable logistic regression, adjusted by selected covariates through the Lasso method, to explore whether RRT-mean is an independent risk factor for PVT. The area under the ROC curve (AUC) was also calculated to assess the model's discriminative ability. P < 0.05 indicated statistical significance.

Results

The liver cirrhosis group consisted of 16 participants with PVT and 32 without PVT. Higher RRT-mean values (odds ratio [OR] 11.4 [95% CI: 2.19, 118]) and lower platelet count (OR 0.98 per 1000 μL [95% CI: 0.96, 0.99]) were independent risk factors for PVT. The incorporation of RRT-mean (AUC, 0.77) alongside platelet count (AUC, 0.75) resulted in an AUC of 0.84. When including healthy control participants, RRT-mean had an adjusted OR of 12.4 and the AUC of the combined model (RRT-mean and platelet count) was 0.90.

Data Conclusion

Prolonged RRT values and low platelet count were significantly associated with the presence of PVT in cirrhotic participants. RRT values derived from 4D Flow MRI may have potential clinical relevance in the management of PVT.

Evidence Level

Technical Efficacy

Stage 2

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将四维血流磁共振成像得出的相对停留时间作为肝硬化相关门静脉血栓形成的标志物进行评估

背景：人们认为门静脉血栓形成（PVT）源于血流停滞，但目前尚缺乏确凿证据。目的：探讨肝硬化患者的相对滞留时间（RRT）值与门静脉血栓形成之间的关系：研究类型：前瞻性：48名肝硬化患者（27名男性，中位年龄为67岁[IQR：57-73]）和20名健康对照组患者（12名男性，中位年龄为45岁[IQR：40-54]）：3 T/4D 流式磁共振成像：评估：分析实验室数据（肝肾功能检测结果和血小板计数）和临床数据（是否存在肿瘤和其他影像学检查结果），以及 4D Flow MRI 得出的门静脉血流动力学数据（时空平均 RRT [RRT-mean]、流速和流量）：我们使用多变量逻辑回归，通过 Lasso 方法对选定的协变量进行调整，以探讨 RRT 平均值是否是 PVT 的独立风险因素。我们还计算了 ROC 曲线下面积（AUC），以评估模型的判别能力。P 结果：肝硬化组包括 16 名 PVT 患者和 32 名无 PVT 患者。较高的 RRT 平均值（几率比 [OR] 11.4 [95% CI: 2.19, 118]）和较低的血小板计数（OR 0.98 per 1000 μL [95% CI: 0.96, 0.99]）是 PVT 的独立危险因素。将 RRT 平均值（AUC, 0.77）与血小板计数（AUC, 0.75）相结合，得出的 AUC 为 0.84。当纳入健康对照参与者时，RRT 平均值的调整 OR 值为 12.4，合并模型（RRT 平均值和血小板计数）的 AUC 值为 0.90：数据结论：RRT 值延长和血小板计数偏低与肝硬化患者出现 PVT 显著相关。从4D血流磁共振成像得出的RRT值可能对PVT的管理具有潜在的临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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