Prediction of portal pressure with liver and spleen MR Elastography and 4D flow phase-contrast MRI

利用肝脏和脾脏 MR 弹性成像和 4D 流相衬 MRI 预测门静脉压力

• 批准号: 10065001
• 负责人: Bachir Taouli
• 金额: $ 47.08万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-12-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10065001
• 关键词: 3-Dimensional; Affect; Alcoholic Liver Cirrhosis; Ascites; Biological Markers; Blood Vessels; Blood flow; Buffers; Catheters; Cicatrix; Cirrhosis; Clinical; Complication; Data; Detection; Development; Diagnosis; Diagnostic; Doppler Ultrasound; Echo-Planar Imaging; Esophageal Varix; Failure; Fibrosis; Frequencies; Gastrointestinal Endoscopy; Goals; Hemorrhage; Hepatic; Hepatic artery; Image; Imaging Techniques; Internal jugular vein structure; Liver; Liver Cirrhosis; Liver Fibrosis; Liver diseases; Liver parenchyma; Magnetic Resonance Imaging; Measurement; Measures; Microcirculation; Modeling; Modulus; Organ; Patient Education; Patients; Performance; Phase; Physiological; Portal Hypertension; Portal Pressure; Portal vein structure; Pre-Clinical Model; Predictive Value of Tests; Property; Protocols documentation; Reproducibility; Resistance; Risk; Sampling; Sampling Errors; Secondary to; Severities; Spleen; System; Techniques; Testing; Tissues; Training; Validation; Varicosity; Vascular resistance; Venous; Venous Pressure level; accurate diagnosis; base; care costs; chronic liver disease; clinically significant; cohort; cost; diagnostic accuracy; elastography; hemodynamics; hepatic vein; high risk; imaging biomarker; intrahepatic; kidney dysfunction; non-invasive imaging; novel; patient population; potential biomarker; pressure; prospective; response; risk stratification; viscoelasticity

Project Summary Liver cirrhosis has been historically classified as a single histopathologic entity, as it is considered to be the latest fibrosis stage; however it is well known that cirrhosis encompasses different degrees of clinical severity. Advanced liver fibrosis and cirrhosis are commonly associated with portal hypertension, which is due to increased hemodynamic resistance of the liver leading to an increase in portal venous pressure. Portal hypertension leads to the development of esophageal varices associated with a high risk of bleeding, ascites and renal dysfunction. The definite diagnosis of portal hypertension is based on the measurement hepatic venous pressure gradient (HVPG), which is an indirect measure of portal pressure. This technique is invasive and not widely available. Portal hypertension may also associated with a decrease in portal venous flow/velocity due to a higher parenchymal resistance to flow, and an increase in hepatic arterial flow secondary to an arterial buffer response that can be measured with phase-contrast magnetic resonance imaging (MRI). According to our recent data, the increased vascular pressure observed in portal hypertension affects liver and spleen stiffness as well as other viscoelastic properties measured with advanced 3D MR elastography, which may potentially be used as biomarkers of portal hypertension. In this proposal, we would like to validate noninvasive imaging biomarkers based on a short multiparametric MRI protocol for the quantification of changes in viscoelastic properties and flow metrics in the liver and spleen in relation with portal hypertension. This protocol could potentially be integrated in routine clinical MRI exams, and could significantly reduce the cost of care by decreasing the need for HVPG measurement, upper gastrointestinal endoscopies, and could provide a novel risk stratification scoring system of liver disease and portal hypertension based on MRI. This will be a highly significant progress in patients with liver disease.

项目摘要 肝肝硬化历史上一直被归类为单一的组织病理学实体，因为它被认为是 最新的纤维化阶段；然而，众所周知，肝硬化包括不同程度的临床严重程度。 晚期肝纤维化和肝硬化通常与门户高血压有关，这是由于 肝脏的血液动力学耐药性增加，导致门静脉压力升高。门户网站 高血压会导致与高出血，腹水的高风险相关的食管静脉曲张的发展 和肾功能障碍。门户高血压的明确诊断是基于测量的肝 静脉压力梯度（HVPG），这是门户压力的间接度量。这项技术是侵入性的 并且不是广泛的。门户高血压也可能与门户静脉的减少有关 由于较高的实质性耐药性以及肝动脉流量的增加，流量/速度因 进行动脉缓冲响应，可以通过相位对比度磁共振成像（MRI）测量。 根据我们最近的数据，在门户高血压中观察到的血管压力增加会影响肝脏和 脾脏刚度以及其他用高级3D MR弹力术测量的粘弹性特性， 可能有可能用作门户高血压的生物标志物。 在此提案中，我们想基于短多参数验证非侵入性成像生物标志物 MRI方案，用于量化肝脏和脾脏中粘弹性特性和流动指标的变化 与门户高血压有关。该方案可能会纳入常规临床MRI检查， 并且可以通过减少对HVPG测量的需求，上层大大降低护理成本 胃肠道内窥镜，可以提供肝病和 基于MRI的门户高血压。在肝病患者中，这将是一个非常重要的进展。

项目成果

Noninvasive imaging assessment of portal hypertension.

• DOI: 10.1007/s00261-020-02729-7
• 发表时间: 2020-11
• 期刊: ABDOMINAL RADIOLOGY
• 影响因子: 2.4
• 作者: Kennedy, Paul;Bane, Octavia;Hectors, Stefanie J.;Fischman, Aaron;Schiano, Thomas;Lewis, Sara;Taouli, Bachir
• 通讯作者: Taouli, Bachir

Quantitative chest computed tomography combined with plasma cytokines predict outcomes in COVID-19 patients.

• DOI: 10.1016/j.heliyon.2022.e10166
• 发表时间: 2022-08
• 期刊: HELIYON
• 影响因子: 4
• 作者: Carbonell, Guillermo;Del Valle, Diane Marie;Gonzalez-Kozlova, Edgar;Marinelli, Brett;Klein, Emma;El Homsi, Maria;Stocker, Daniel;Chung, Michael;Bernheim, Adam;Simons, Nicole W.;Xiang, Jiani;Nirenberg, Sharon;Kovatch, Patricia;Lewis, Sara;Merad, Miriam;Gnjatic, Sacha;Taouli, Bachir
• 通讯作者: Taouli, Bachir

4D flow MRI in abdominal vessels: prospective comparison of k-t accelerated free breathing acquisition to standard respiratory navigator gated acquisition.

• DOI: 10.1038/s41598-022-23864-9
• 发表时间: 2022-11-18
• 期刊: Scientific reports
• 影响因子: 4.6

Collagen-targeted MRI contrast agent for liver fibrosis detection.

• DOI: 10.1038/s41575-020-0266-z
• 发表时间: 2020-04
• 期刊: Nature reviews. Gastroenterology & hepatology
• 作者: Kennedy P;Taouli B
• 通讯作者: Taouli B

MR elastography outperforms shear wave elastography for the diagnosis of clinically significant portal hypertension.

• DOI: 10.1007/s00330-022-08935-9
• 发表时间: 2022-12
• 期刊: EUROPEAN RADIOLOGY
• 影响因子: 5.9
• 作者: Kennedy, Paul;Stocker, Daniel;Carbonell, Guillermo;Said, Daniela;Bane, Octavia;Hectors, Stefanie;Abboud, Ghadi;Cuevas, Jordan;Bolster, Bradley D., Jr.;Friedman, Scott L.;Lewis, Sara;Schiano, Thomas;Bhattacharya, Dipankar;Fischman, Aaron;Thung, Swan;Taouli, Bachir
• 通讯作者: Taouli, Bachir