Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Radiol Med. 2022 Nov;127(11):1181-1198. doi: 10.1007/s11547-022-01553-x. Epub 2022 Sep 19.
Thus far, ultrasound, CT, and 2D cine phase-contrast MRI has been adopted to evaluate blood flow and vascular morphology in the portal venous system; however, all these techniques have some shortcomings, such as limited field of view and difficulty in accurately evaluating blood flow. A new imaging technique, namely 3D cine phase-contrast (4D Flow) MRI, can acquire blood flow data of the entire abdomen at once and in a time-resolved manner, allowing visual, quantitative, and comprehensive assessment of blood flow in the portal venous system. In addition, a retrospective blood flow analysis, i.e., "retrospective flowmetry," is possible. Although the development of 4D Flow MRI for the portal system has been delayed compared to that for the arterial system owing to the lower flow velocity of the portal venous system and the presence of respiratory artifacts, several useful reports have recently been published as the technology has advanced. In the first part of this narrative review article, technical considerations of image acquisition and analysis methods of 4D Flow MRI for the portal venous system and the validations of their results are described. In the second part, the current clinical application of 4D Flow MRI for the portal venous system is reviewed.
迄今为止,超声、CT 和二维电影相位对比 MRI 已被用于评估门静脉系统中的血流和血管形态;然而,所有这些技术都有一些缺点,例如视野有限,难以准确评估血流。一种新的成像技术,即三维电影相位对比(4D Flow)MRI,可以一次性以时间分辨的方式获取整个腹部的血流数据,从而可以对门静脉系统中的血流进行直观、定量和全面的评估。此外,还可以进行回顾性血流分析,即“回顾性流量测量”。尽管由于门静脉系统的血流速度较低和呼吸伪影的存在,4D Flow MRI 技术在门静脉系统中的发展相对于动脉系统来说有所滞后,但随着技术的进步,最近已经发表了一些有用的报告。在这篇叙述性综述文章的第一部分,描述了门静脉系统 4D Flow MRI 的图像采集和分析方法的技术考虑因素及其结果的验证。在第二部分,回顾了门静脉系统 4D Flow MRI 的当前临床应用。