The role of helical flow phenomenon in the main portal vein as a biomarker for esophageal varices at high risk of bleeding in patients with cirrhosis

Motivation: There is clinical demand for a non-invasive method that can accurately predict the presence of esophageal varices (EVs) at high risk of bleeding in cirrhotic patients. Goal(s): This study evaluated the role of 4-dimensional flow MRI in screening cirrhotic patients complicated by EVs at high risk of bleeding. Approach: A total of 106 cirrhotic patients underwent 4D flow MRI. In-plane velocity data at main portal vein were analyzed to obtain through-plane vorticity, as a marker of helical flow. Results: The helical flow phenomenon of the main portal vein was negatively correlated with the presence of EVs at high risk of bleeding. Impact: This study demonstrated that the helical flow phenomenon of main portal vein derived from 4D flow MRI could play an important role in predicting the presence of esophageal varices at high risk of bleeding in cirrhotic patients.