{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:57:21Z","timestamp":1781153841075,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["RS\u20102023\u201000245913"],"award-info":[{"award-number":["RS\u20102023\u201000245913"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["RS\u20102024\u201000333646"],"award-info":[{"award-number":["RS\u20102024\u201000333646"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["RS\u20102024\u201000449148"],"award-info":[{"award-number":["RS\u20102024\u201000449148"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["RS\u20102025\u201002653196"],"award-info":[{"award-number":["RS\u20102025\u201002653196"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["RS\u20102025\u201025396353"],"award-info":[{"award-number":["RS\u20102025\u201025396353"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["HI22C1915"],"award-info":[{"award-number":["HI22C1915"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["RS\u20102025\u201002263007"],"award-info":[{"award-number":["RS\u20102025\u201002263007"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["RS\u20102025\u201019252970"],"award-info":[{"award-number":["RS\u20102025\u201019252970"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Bleeding risk assessment of esophageal varices (EVs) is commonly performed in liver cirrhosis. However, existing approaches are often invasive or insufficient to fully capture bleeding risk.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To investigate portal venous hemodynamics and vessel geometry associated with EVs severity in cirrhotic patients using four\u2010dimensional flow MRI as a noninvasive approach to support clinical risk assessment.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Retrospective.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n \n One\u2010hundred and four cirrhotic patients consisting of patients without EVs (Group 1,\n n<\/jats:italic>\n \u2009=\u200948), with low\u2010risk EVs (Group 2,\n n<\/jats:italic>\n \u2009=\u200937), and high\u2010risk EVs (Group 3,\n n<\/jats:italic>\n \u2009=\u200919).\n <\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n 3\u2009T, a three\u2010directional, velocity\u2010encoded gradient echo sequence with Cartesian k\u2010space sampling.<\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n \n Flow rate, mean velocity, and fractional flow changes in main portal vein (PV); effective vessel diameter and vessel angle; and rotational flow including vorticity, helicity, helical flow intensity (\n h<\/jats:italic>\n 2<\/jats:sub>\n ), localized normalized helicity, and vortex volume.\n <\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n One\u2010way ANOVA with Tukey's post hoc test or Kruskal\u2013Wallis followed by Conover's post hoc test. Receiver operating characteristic (ROC) curve analysis. Significance level set at\n p<\/jats:italic>\n \u2009<\u20090.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Significant group differences were observed for flow rate at the proximal PV (\n \u03b5<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.05) and for mean PV velocity at both proximal (\n \u03b5<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.13) and distal locations (\n \u03b7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.11). In contrast, neither fractional portal venous flow nor vessel angle measurements differed across groups (\n p<\/jats:italic>\n \u2009=\u20090.294 and all\n p<\/jats:italic>\n \u2009\u2265\u20090.475, respectively). Among rotational flow biomarkers, vorticity differentiated Group 3 from both Groups 1 and 2 (Group 1: 17.86\u2009\u00b1\u20093.26\u2009s\n \u22121<\/jats:sup>\n , Group 2: 16.65\u2009\u00b1\u20094.58\u2009s\n \u22121<\/jats:sup>\n , Group 3: 13.59\u2009\u00b1\u20093.23\u2009s\n \u22121<\/jats:sup>\n ;\n \u03b7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.15), with an area under the ROC curve of 0.77 (sensitivity\u2009=\u20090.79, specificity\u2009=\u20090.62).\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n Rotational flow biomarkers may support current risk assessment in cirrhotic patients with high\u2010risk EVs.<\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n 4.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 2.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70287","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T04:09:11Z","timestamp":1773202151000},"page":"283-293","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploratory\n 4D<\/scp>\n Flow\n MRI<\/scp>\n Study of Portal Venous Rotational Flow for High\u2010Risk Esophageal Varices in Cirrhosis"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9910-631X","authenticated-orcid":false,"given":"Sungho","family":"Park","sequence":"first","affiliation":[{"name":"Medical Device Development Center, Daegu\u2010Gyeongbuk Medical Innovation Foundation Daegu Republic of Korea"},{"name":"Department of Radiology, Section of Pediatric Radiology Children's Hospital Colorado, University of Colorado Anschutz Medical Campus Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung","family":"Man Moon","sequence":"additional","affiliation":[{"name":"Research Institute of Medical Sciences, Chonnam National University Hwasun\u2010gun Jeollanam\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minseong","family":"Kwon","sequence":"additional","affiliation":[{"name":"Medical Device Development Center, Daegu\u2010Gyeongbuk Medical Innovation Foundation Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suk Hee","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Radiology Chonnam National University Medical School Gwangju Republic of Korea"},{"name":"Department of Radiology Chonnam National University Hwasun Hospital Hwasun\u2010gun Jeollanam\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1200-9462","authenticated-orcid":false,"given":"Yun Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology Chonnam National University Medical School Gwangju Republic of Korea"},{"name":"Department of Radiology Chonnam National University Hospital Gwangju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9198-775X","authenticated-orcid":false,"given":"Mun Young","family":"Paek","sequence":"additional","affiliation":[{"name":"Siemens Healthineers Ltd. 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