{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T01:37:38Z","timestamp":1792978658305,"version":"4.5.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T00:00:00Z","timestamp":1596499200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T00:00:00Z","timestamp":1596499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Bonn"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>In patients with advanced liver disease, portal hypertension is an important risk factor, leading to complications such as esophageal variceal bleeding, ascites, and hepatic encephalopathy. This study aimed to determine the diagnostic value of T1 and T2 mapping and extracellular volume fraction (ECV) for the non-invasive assessment of portal hypertension.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this prospective study, 50 participants (33 patients with indication for trans-jugular intrahepatic portosystemic shunt (TIPS) and 17 healthy volunteers) underwent MRI. The derivation and validation cohorts included 40 and 10 participants, respectively. T1 and T2 relaxation times and ECV of the liver and the spleen were assessed using quantitative mapping techniques. Direct hepatic venous pressure gradient (HVPG) and portal pressure measurements were performed during TIPS procedure. ROC analysis was performed to compare diagnostic performance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Splenic ECV correlated with portal pressure (<jats:italic>r<\/jats:italic>\u2009=\u20090.72; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and direct HVPG (<jats:italic>r<\/jats:italic>\u2009=\u20090.50; <jats:italic>p<\/jats:italic>\u2009=\u20090.003). No significant correlations were found between native splenic T1 and T2 relaxation times with portal pressure measurements (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05, respectively). In the derivation cohort, splenic ECV revealed a perfect diagnostic performance with an AUC of 1.000 for the identification of clinically significant portal hypertension (direct HVPG \u2265\u200910\u00a0mmHg) and outperformed other parameters: hepatic T2 (AUC, 0.731), splenic T2 (AUC, 0.736), and splenic native T1 (AUC, 0.806) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05, respectively). The diagnostic performance of mapping parameters was comparable in the validation cohort.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Splenic ECV was associated with portal pressure measurements in patients with advanced liver disease. Future studies should explore the diagnostic\u00a0value of parametric mapping accross a broader range of pressure values.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:italic>\u2022 Non-invasive assessment and monitoring of portal hypertension is an area of unmet interest.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Splenic extracellular volume fraction is strongly associated with portal pressure in patients with end-stage liver disease.<\/jats:italic><\/jats:p>\n                <jats:p>\u2022 <jats:italic>Quantitative splenic and hepatic MRI-derived parameters have a potential to become a new non-invasive diagnostic parameter to assess and monitor portal pressure.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-020-07080-5","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T12:02:36Z","timestamp":1596542556000},"page":"85-93","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Magnetic resonance parametric mapping of the spleen for non-invasive assessment of portal hypertension"],"prefix":"10.1007","volume":"31","author":[{"given":"Narine","family":"Mesropyan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Isaak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Faron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Praktiknjo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Jansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kuetting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus C.","family":"Pieper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alois M.","family":"Sprinkart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burkhard","family":"Maedler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Kupczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Attenberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7715-4636","authenticated-orcid":false,"given":"Julian A.","family":"Luetkens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,4]]},"reference":[{"issue":"1","key":"7080_CR1","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1148\/radiol.14141435","volume":"275","author":"S Bandula","year":"2015","unstructured":"Bandula S, Punwani S, Rosenberg WM et al (2015) Equilibrium contrast-enhanced CT imaging to evaluate hepatic fibrosis: initial validation by comparison with histopathologic sampling. Radiology 275(1):136\u2013143","journal-title":"Radiology"},{"issue":"4","key":"7080_CR2","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1002\/hep.21327","volume":"44","author":"M Ekstedt","year":"2006","unstructured":"Ekstedt M, Franz\u00e9n LE, Mathiesen UL et al (2006) Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology 44(4):865\u2013873","journal-title":"Hepatology"},{"issue":"9","key":"7080_CR3","first-page":"647","volume":"5","author":"F Siqueira","year":"2009","unstructured":"Siqueira F, Kelly T, Saab S (2009) Refractory ascites: pathogenesis, clinical impact, and management. Gastroenterol Hepatol (N Y) 5(9):647\u2013656","journal-title":"Gastroenterol Hepatol (N Y)"},{"issue":"4","key":"7080_CR4","doi-asserted-by":"publisher","first-page":"688","DOI":"10.4254\/wjh.v7.i4.688","volume":"7","author":"V La Mura","year":"2015","unstructured":"La Mura V, Nicolini A, Tosetti G, Primignani M (2015) Cirrhosis and portal hypertension: the importance of risk stratification, the role of hepatic venous pressure gradient measurement. World J Hepatol 7(4):688\u2013695","journal-title":"World J Hepatol"},{"issue":"3","key":"7080_CR5","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1016\/j.jhep.2015.07.001","volume":"63","author":"PS Kamath","year":"2015","unstructured":"Kamath PS, Mookerjee RP (2015) Individualized care for portal hypertension: not quite yet. J Hepatol 63(3):543\u2013545","journal-title":"J Hepatol"},{"issue":"2","key":"7080_CR6","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1053\/j.gastro.2007.05.024","volume":"133","author":"C Ripoll","year":"2007","unstructured":"Ripoll C, Groszmann R, Garcia-Tsao G et al (2007) Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Gastroenterology 133(2):481\u2013488","journal-title":"Gastroenterology"},{"issue":"3","key":"7080_CR7","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1136\/gutjnl-2017-314561","volume":"67","author":"JA Luetkens","year":"2018","unstructured":"Luetkens JA, Klein S, Traeber F et al (2018) Quantitative liver MRI including extracellular volume fraction for non-invasive quantification of liver fibrosis: a prospective proof-of-concept study. Gut 67(3):593\u2013594","journal-title":"Gut"},{"issue":"3","key":"7080_CR8","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1148\/radiol.2018180051","volume":"288","author":"JA Luetkens","year":"2018","unstructured":"Luetkens JA, Klein S, Tr\u00e4ber F et al (2018) Quantification of liver fibrosis at T1 and T2 mapping with extracellular volume fraction MRI: preclinical results. Radiology 288(3):748\u2013754","journal-title":"Radiology"},{"issue":"3","key":"7080_CR9","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1148\/radiol.2016141802","volume":"278","author":"EB Schelbert","year":"2016","unstructured":"Schelbert EB, Messroghli DR (2016) State of the art: clinical applications of cardiac T1 mapping. Radiology 278(3):658\u2013676","journal-title":"Radiology"},{"key":"7080_CR10","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/1532-429X-15-92","volume":"15","author":"JC Moon","year":"2013","unstructured":"Moon JC, Messroghli DR, Kellman P et al (2013) Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement. J Cardiovasc Magn Reson 15:92","journal-title":"J Cardiovasc Magn Reson"},{"issue":"2","key":"7080_CR11","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1161\/CIRCULATIONAHA.109.930636","volume":"122","author":"AS Flett","year":"2010","unstructured":"Flett AS, Hayward MP, Ashworth MT et al (2010) Equilibrium contrast cardiovascular magnetic resonance for the measurement of diffuse myocardial fibrosis: preliminary validation in humans. Circulation 122(2):138\u2013144","journal-title":"Circulation"},{"issue":"8","key":"7080_CR12","doi-asserted-by":"publisher","first-page":"e0221066","DOI":"10.1371\/journal.pone.0221066","volume":"14","author":"C Levick","year":"2019","unstructured":"Levick C, Phillips-Hughes J, Collier J et al (2019) Non-invasive assessment of portal hypertension by multi-parametric magnetic resonance imaging of the spleen: a proof of concept study. PLoS One 14(8):e0221066","journal-title":"PLoS One"},{"issue":"1","key":"7080_CR13","doi-asserted-by":"publisher","first-page":"9189","DOI":"10.1038\/s41598-018-27560-5","volume":"8","author":"N McDonald","year":"2018","unstructured":"McDonald N, Eddowes PJ, Hodson J et al (2018) Multiparametric magnetic resonance imaging for quantitation of liver disease: a two-centre cross-sectional observational study. Sci Rep 8(1):9189","journal-title":"Sci Rep"},{"key":"7080_CR14","doi-asserted-by":"publisher","unstructured":"Hoy AM, McDonald N, Lennen RJ et al (2018) Non-invasive assessment of liver disease in rats using multiparametric magnetic resonance imaging: a feasibility study. Biol Open. https:\/\/doi.org\/10.1242\/bio.033910","DOI":"10.1242\/bio.033910"},{"issue":"1","key":"7080_CR15","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1053\/jhep.2003.50315","volume":"38","author":"KP Moore","year":"2003","unstructured":"Moore KP, Wong F, Gines P et al (2003) The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club. Hepatology 38(1):258\u2013266","journal-title":"Hepatology"},{"issue":"1","key":"7080_CR16","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1002\/mrm.20110","volume":"52","author":"DR Messroghli","year":"2004","unstructured":"Messroghli DR, Radjenovic A, Kozerke S, Higgins DM, Sivananthan MU, Ridgway JP (2004) Modified Look-Locker inversion recovery (MOLLI) for high-resolution T1 mapping of the heart. Magn Reson Med 52(1):141\u2013146","journal-title":"Magn Reson Med"},{"issue":"1","key":"7080_CR17","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s41747-019-0100-y","volume":"3","author":"JA Luetkens","year":"2019","unstructured":"Luetkens JA, Klein S, Tr\u00e4ber F et al (2019) Quantification of liver fibrosis: extracellular volume fraction using an MRI bolus-only technique in a rat animal model. Eur Radiol Exp 3(1):22","journal-title":"Eur Radiol Exp"},{"key":"7080_CR18","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s12968-015-0127-z","volume":"17","author":"AM Sprinkart","year":"2015","unstructured":"Sprinkart AM, Luetkens JA, Tr\u00e4ber F et al (2015) Gradient spin echo (GraSE) imaging for fast myocardial T2 mapping. J Cardiovasc Magn Reson 17:12","journal-title":"J Cardiovasc Magn Reson"},{"issue":"3","key":"7080_CR19","doi-asserted-by":"publisher","first-page":"837","DOI":"10.2307\/2531595","volume":"44","author":"ER DeLong","year":"1988","unstructured":"DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44(3):837\u2013845","journal-title":"Biometrics"},{"issue":"4","key":"7080_CR20","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1016\/j.cld.2008.07.008","volume":"12","author":"RG Wells","year":"2008","unstructured":"Wells RG (2008) Cellular sources of extracellular matrix in hepatic fibrosis. Clin Liver Dis 12(4):759\u2013768","journal-title":"Clin Liver Dis"},{"key":"7080_CR21","first-page":"8720367","volume":"2017","author":"A M\u00fcller","year":"2017","unstructured":"M\u00fcller A, Hochrath K, Stroeder J et al (2017) Effects of liver fibrosis progression on tissue relaxation times in different mouse models assessed by ultrahigh field magnetic resonance imaging. Biomed Res Int 2017:8720367","journal-title":"Biomed Res Int"},{"issue":"3","key":"7080_CR22","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1007\/s00261-019-02382-9","volume":"45","author":"DH Hoffman","year":"2020","unstructured":"Hoffman DH, Ayoola A, Nickel D, Han F, Chandarana H, Shanbhogue KP (2020) T1 mapping, T2 mapping and MR elastography of the liver for detection and staging of liver fibrosis. Abdom Radiol (NY) 45(3):692\u2013700","journal-title":"Abdom Radiol (NY)"},{"key":"7080_CR23","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.mri.2019.03.002","volume":"59","author":"H-Q Wang","year":"2019","unstructured":"Wang H-Q, Jin K-P, Zeng M-S et al (2019) Assessing liver fibrosis in chronic hepatitis B using MR extracellular volume measurements: comparison with serum fibrosis indices. Magn Reson Imaging 59:39\u201345","journal-title":"Magn Reson Imaging"},{"key":"7080_CR24","doi-asserted-by":"publisher","unstructured":"Hoffman DH, Ayoola A, Nickel D et al (2020) MR elastography, T1 and T2 relaxometry of liver: role in noninvasive assessment of liver function and portal hypertension. Abdom Radiol (NY). https:\/\/doi.org\/10.1007\/s00261-020-02432-7","DOI":"10.1007\/s00261-020-02432-7"},{"issue":"7","key":"7080_CR25","doi-asserted-by":"publisher","first-page":"2403","DOI":"10.1007\/s00261-019-01990-9","volume":"44","author":"P Ramachandran","year":"2019","unstructured":"Ramachandran P, Serai SD, Veldtman GR et al (2019) Assessment of liver T1 mapping in fontan patients and its correlation with magnetic resonance elastography-derived liver stiffness. Abdom Radiol (NY) 44(7):2403\u20132408","journal-title":"Abdom Radiol (NY)"},{"issue":"2","key":"7080_CR26","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/S1590-8658(02)80246-8","volume":"34","author":"M Bolognesi","year":"2002","unstructured":"Bolognesi M, Merkel C, Sacerdoti D, Nava V, Gatta A (2002) Role of spleen enlargement in cirrhosis with portal hypertension. Dig Liver Dis 34(2):144\u2013150","journal-title":"Dig Liver Dis"},{"issue":"3","key":"7080_CR27","doi-asserted-by":"publisher","first-page":"e004091","DOI":"10.1161\/CIRCIMAGING.115.004091","volume":"9","author":"JA Luetkens","year":"2016","unstructured":"Luetkens JA, Doerner J, Schwarze-Zander C et al (2016) Cardiac magnetic resonance reveals signs of subclinical myocardial inflammation in asymptomatic HIV-infected patients. Circ Cardiovasc Imaging 9(3):e004091","journal-title":"Circ Cardiovasc Imaging"},{"issue":"2","key":"7080_CR28","doi-asserted-by":"publisher","first-page":"103","DOI":"10.21037\/qims.2016.03.02","volume":"6","author":"AR Guimaraes","year":"2016","unstructured":"Guimaraes AR, Siqueira L, Uppal R et al (2016) T2 relaxation time is related to liver fibrosis severity. Quant Imaging Med Surg 6(2):103\u2013114","journal-title":"Quant Imaging Med Surg"},{"issue":"6","key":"7080_CR29","doi-asserted-by":"publisher","first-page":"e009100","DOI":"10.1161\/CIRCIMAGING.119.009100","volume":"12","author":"JA Luetkens","year":"2019","unstructured":"Luetkens JA, von Landenberg C, Isaak A et al (2019) Comprehensive cardiac magnetic resonance for assessment of cardiac involvement in Myotonic muscular dystrophy type 1 and 2 without known cardiovascular disease. Circ Cardiovasc Imaging 12(6):e009100","journal-title":"Circ Cardiovasc Imaging"},{"key":"7080_CR30","doi-asserted-by":"crossref","unstructured":"Han X, An W, Cao Q, Liu C, Shang S, Zhao L (2020) Noninvasive evaluation of esophageal varices in cirrhotic patients based on spleen hemodynamics: a dual-energy CT study. Eur Radiol 30:3210\u20133216","DOI":"10.1007\/s00330-020-06680-5"},{"key":"7080_CR31","doi-asserted-by":"publisher","first-page":"6611","DOI":"10.1007\/s00330-019-06230-8","volume":"29","author":"H Abe","year":"2019","unstructured":"Abe H, Midorikawa Y, Matsumoto N et al (2019) Prediction of esophageal varices by liver and spleen MR elastography. Eur Radiol 29:6611\u20136619","journal-title":"Eur Radiol"}],"container-title":["European Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-020-07080-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00330-020-07080-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-020-07080-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T23:22:21Z","timestamp":1628032941000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00330-020-07080-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,4]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["7080"],"URL":"https:\/\/doi.org\/10.1007\/s00330-020-07080-5","relation":{},"ISSN":["0938-7994","1432-1084"],"issn-type":[{"value":"0938-7994","type":"print"},{"value":"1432-1084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,4]]},"assertion":[{"value":"6 May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2020","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2020","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2020","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The scientific guarantor of this publication is Julian A. Luetkens.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors (Julian A. Luetkens) has significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained from all subjects (patients) in this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"\u2022 retrospective\u2022 observational\u2022 performed at one institution","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}