Predicting Variceal Risk in Cirrhotic Patients Using Four-Dimensional Flow MRI for Hemodynamic Assessment and Risk Stratification

Motivation: Current methods for predicting variceal risk in advanced cirrhosis are invasive or lack precision, necessitating reliable non-invasive alternatives to improve clinical care. Goal(s): To validate abdominal four-dimensional(4D) flow MRI as a non-invasive tool for assessing variceal risk by quantifying portal hemodynamic changes in cirrhotic patients. Approach: Eighty participants, including cirrhotic patients and healthy controls, underwent 4D flow MRI to measure flow rate (FR) and vessel diameter (VD) in the main portal vein (MPV) and splenic vein (SV). Results: The combination of FR and VD from the MPV and SV yielded the most robust risk prediction, effectively stratifying patients by variceal risk level. Impact: 4D flow MRI provides a reliable non-invasive method for assessing variceal risk by quantifying key hemodynamic changes. It enables early intervention and personalized treatment strategies, improving patient outcomes and offering new insights into managing portal hypertension in cirrhotic patients.