MRI assessment of altered dynamic changes in liver haemodynamics following a meal challenge in compensated cirrhosis

Cox, Eleanor F.; Palaniyappan, Naaventhan; Aithal, Guruprasad P.; Guha, Indra Neil; Francis, Susan T.

Abstract

Background: To use magnetic resonance imaging (MRI) to dynamically assess postprandial changes in hepatic and collateral blood flow, liver perfusion and oxygenation in healthy participants and patients with liver disease with compensated cirrhosis (CC).
Methods: We evaluated blood flow in the portal vein, hepatic artery, and azygos vein (using phase-contrast MRI), liver perfusion (using arterial spin labelling) and blood oxygenation (using transverse relaxation time [T2*] mapping). Measures were collected at baseline and at 6-7 min intervals from 20 to 65 min following a test meal (440 ml; 660 kcal) in 10 healthy participants and 10 CC patients.
Results: In healthy participants, we observed a significant postprandial increase in portal vein flow from baseline (+137 ± 26% [mean ± standard deviation], p < 0.001) coupled with a reduction in hepatic artery flow from baseline (-30 ±18%, p = 0.008), reflecting the hepatic artery buffer response. In CC patients, a lower but still significant increase in portal vein (67 ±50 %, p = 0.014) was observed, without a clear hepatic artery buffer response. Healthy participants showed a significant increase in postprandial liver perfusion (138 ± 75%, p < 0.001), not observed in CC patients. There was no change in liver T2* for either group.
Conclusions: Postprandial changes in liver perfusion, oxygenation, and hepatic and collateral circulation can be measured non-invasively using MRI. Differences between healthy participants and CC patients were shown, which may help stratify liver cirrhosis in patients.

Citation

Cox, E. F., Palaniyappan, N., Aithal, G. P., Guha, I. N., & Francis, S. T. (2018). MRI assessment of altered dynamic changes in liver haemodynamics following a meal challenge in compensated cirrhosis. European Radiology Experimental, 2, Article 26. https://doi.org/10.1186/s41747-018-0056-3

• Journal Article Type: Article
• Acceptance Date: Jun 21, 2018
• Online Publication Date: Sep 26, 2018
• Publication Date: Sep 26, 2018
• Deposit Date: Sep 4, 2018
• Publicly Available Date: Oct 2, 2018
• Electronic ISSN: 2509-9280
• Publisher: SpringerOpen
• Peer Reviewed: Peer Reviewed
• Volume: 2
• Article Number: 26
• DOI: https://doi.org/10.1186/s41747-018-0056-3
• Keywords: Arterial spin labelling (ASL); Liver cirrhosis; Magnetic resonance imaging (MRI); Perfusion; T2* mapping
• Public URL: https://nottingham-repository.worktribe.com/output/1059659
• Publisher URL: https://eurradiolexp.springeropen.com/articles/10.1186/s41747-018-0056-3
• Contract Date: Oct 2, 2018