{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:35:34Z","timestamp":1779917734804,"version":"3.53.1"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Non\u2010invasive assessment of the hemodynamic changes of cirrhosis might help guide management of patients with liver disease but are currently limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine whether free\u2010breathing 4D flow MRI can be used to quantify the hemodynamic effects of cirrhosis and introduce hydraulic circuit indexes of severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Forty\u2010seven patients including 26 with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3\u2009T\/free\u2010breathing 4D flow MRI with soft gating and golden\u2010angle view ordering.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Measurements of the supra\u2010celiac abdominal aorta, supra\u2010renal abdominal aorta (SRA), celiac trunk (CeT), superior mesenteric artery (SMA), splenic artery (SpA), common hepatic artery (CHA), portal vein (PV), and supra\u2010renal inferior vena cava (IVC) were made by two radiologists. Measures of hepatic vascular resistance (hepatic arterial relative resistance [HARR]; portal resistive index [PRI]) were proposed and calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Analysis<\/jats:title><jats:p>Bland\u2013Altman, Pearson's correlation, Tukey's multiple comparison, and Cohen's kappa. <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 was considered significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010four of 47 studies yielded adequate image quality for flow quantification (94%). Arterial structures showed high inter\u2010reader concordance (range; <jats:italic>\u03c1<\/jats:italic> = 0.948\u20130.987) and the IVC (<jats:italic>\u03c1<\/jats:italic> = 0.972), with moderate concordance in the PV (<jats:italic>\u03c1<\/jats:italic> = 0.866). Conservation of mass analysis showed concordance between large vessels (SRA vs. IVC; <jats:italic>\u03c1<\/jats:italic> = 0.806), small vessels (celiac vs. CHA\u2009+\u2009SpA; <jats:italic>\u03c1<\/jats:italic> = 0.939), and across capillary beds (CeT\u2009+\u2009SMA vs. PV; <jats:italic>\u03c1<\/jats:italic> = 0.862). Splanchnic flow was increased in patients with portosystemic shunting (PSS) relative to control patients and patients with cirrhosis without PSS (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05, difference range 0.11\u20130.68\u2009liter\/m). HARR was elevated and PRI was decreased in patients with PSS (3.55 and 1.49, respectively) compared to both the control (2.11\/3.18) and non\u2010PSS (2.11\/2.35) cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>4D flow MRI with self\u2010navigation was technically feasible, showing promise in quantifying the hemodynamic effects of cirrhosis. Proposed quantitative metrics of hepatic vascular resistance correlated with PSS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy Stage<\/jats:title><jats:p>2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.27488","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T05:32:20Z","timestamp":1613799140000},"page":"1410-1421","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Quantification of the Hemodynamic Changes of Cirrhosis with Free\u2010Breathing Self\u2010Navigated <scp>MRI<\/scp>"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0116-3517","authenticated-orcid":false,"given":"Ryan L.","family":"Brunsing","sequence":"first","affiliation":[{"name":"Department of Radiology Stanford University  Palo Alto California 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