Risk stratification of esophageal varices in patients with liver cirrhosis using 4D Flow MRI

Motivation: Esophageal varices (EVs) increase mortality risk in patients with liver cirrhosis (LC). However, the impact of EVs on portal vein (PV) flow characteristics is poorly understood. Goal(s): This study aimed to explore flow patterns associated with EV risk using 4D flow MRI in LC patients. Approach: A cohort of 104 LC patients was divided into three groups based on EV presence and severity. We evaluated flow volume, angles, and advanced flow markers. Results: Advanced flow markers can identify patients with LC and EVs with red-color signs, demonstrating their potential as non-invasive markers for EV risk. Impact: This study highlights 4D flow-based advanced markers for assessing esophageal varices risk. These findings support improved risk stratification methods that may enhance clinical management for high-risk patients.