4D flow MRI-guided treatment of portal-hypertensive complications in a patient with multiple extrahepatic arterioportal shunts
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4D flow MRI-guided treatment of portal-hypertensive complications in a patient with multiple extrahepatic arterioportal shunts. / Riedel, Christoph; Bannas, Peter; Lenz, Alexander; Ittrich, Harald; Perez, Daniel; Adam, Gerhard; Lohse, Ansgar W; Kluwe, Johannes; Piecha, Felix.
in: MAGN RESON IMAGING, Jahrgang 101, 09.2023, S. 54-56.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › Case Report › Forschung › Begutachtung
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TY - JOUR
T1 - 4D flow MRI-guided treatment of portal-hypertensive complications in a patient with multiple extrahepatic arterioportal shunts
AU - Riedel, Christoph
AU - Bannas, Peter
AU - Lenz, Alexander
AU - Ittrich, Harald
AU - Perez, Daniel
AU - Adam, Gerhard
AU - Lohse, Ansgar W
AU - Kluwe, Johannes
AU - Piecha, Felix
N1 - Copyright © 2023 Elsevier Inc. All rights reserved.
PY - 2023/9
Y1 - 2023/9
N2 - Portal hypertension is the underlying reason for complications like ascites or gastrointestinal varices in end-stage liver disease. On rare occasions, portal hypertension may be caused by extrahepatic arterioportal shunts. This report illustrates an outstanding case of extrahepatic arterioportal shunting as an uncommon cause of TIPS-refractory portal hypertension. Four-dimensional flow magnetic resonance imaging (4D flow MRI) is a novel non-invasive technique that enables the visualization of complex vascular disorders but has not been put into daily clinical practice in hepatology. In this case, 4D flow MRI enabled the visualization of three abdominal arterioportal shunts as the reason for TIPS-refractory portal hypertension. The quantification of individual shunt flow rates by 4D flow MRI guided our treatment strategy consisting of embolization during interventional angiography and surgical resection of all three arterioportal shunts. In conclusion, this case highlights the usefulness of 4D flow MRI for evaluating shunt flow in cases of complex vascular disorders and portal-hypertensive complications, thus helping to guide therapeutic decisions and monitoring the therapeutic success.
AB - Portal hypertension is the underlying reason for complications like ascites or gastrointestinal varices in end-stage liver disease. On rare occasions, portal hypertension may be caused by extrahepatic arterioportal shunts. This report illustrates an outstanding case of extrahepatic arterioportal shunting as an uncommon cause of TIPS-refractory portal hypertension. Four-dimensional flow magnetic resonance imaging (4D flow MRI) is a novel non-invasive technique that enables the visualization of complex vascular disorders but has not been put into daily clinical practice in hepatology. In this case, 4D flow MRI enabled the visualization of three abdominal arterioportal shunts as the reason for TIPS-refractory portal hypertension. The quantification of individual shunt flow rates by 4D flow MRI guided our treatment strategy consisting of embolization during interventional angiography and surgical resection of all three arterioportal shunts. In conclusion, this case highlights the usefulness of 4D flow MRI for evaluating shunt flow in cases of complex vascular disorders and portal-hypertensive complications, thus helping to guide therapeutic decisions and monitoring the therapeutic success.
KW - Humans
KW - Hypertension, Portal/etiology
KW - Magnetic Resonance Imaging/adverse effects
KW - Embolization, Therapeutic/adverse effects
U2 - 10.1016/j.mri.2023.03.018
DO - 10.1016/j.mri.2023.03.018
M3 - Case report
C2 - 37011771
VL - 101
SP - 54
EP - 56
JO - MAGN RESON IMAGING
JF - MAGN RESON IMAGING
SN - 0730-725X
ER -
