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Transit time ultrasound perivascular flow probe technology is superior to MR imaging on hepatic blood flow measurement in a porcine model

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Hepatobiliary & Pancreatic Diseases International 2018年第6期17卷 538-545页

作者： Mohamed Bekheit chloe audebert Petru Bucur Hans Adriaensen Emilie Bled Mylène Wartenberg Irene Vignon-Clementel Eric Vibert Inserm Unité 1193 112 Boulevard Paul Valliant CuturierVillejuifFrance Institute of medical sciences University of AberdeenAberdeenUK Centre de recherche Inria de Paris ParisFrance Sorbonne Universités UPMC University of Paris 6Laboratoire Jacques-LouisLionsParisFrance CHRU hopitaux de ToursChirurgie Héato-biliaire et pancréatiqueTransplantation HéatiqueToursFrance Plateforme Chirurgie et Imagerie pour le Recherche et l’Enseignement(CIRE) ImagerieUMR-PRC37380 NouzillyCentre INRA Val de LoireFrance AP-HP Hoital Paul BrousseCentre Héato-BiliaireVillejuifFrance

Background: The hepatic hemodynamics is an essential parameter in surgical planning as well as in various disease processes. The transit time ultrasound(TTUS) perivascular flow probe technology is widely used in clinical practice to evaluate the hepatic inflow, yet invasive. The phase-contrast-MRI(PC-MRI) is not invasive and potentially applicable in assessing the hepatic blood flow. In the present study, we compared the hepatic inflow rates using the PC-MRI and the TTUS probe, and evaluated their predictive value of post-hepatectomy adverse events. Methods: Eighteen large white pigs were anaesthetized for PC-MRI and approximately 75% hepatic resection was performed under a unified protocol. The blood flow was measured in the hepatic artery(Qha), the portal vein(Qpv), and the aorta above the celiac trunk(Qca) using PC-MRI, and was compared to the TTUS probe. The Bland-Altman method was conducted and a partial least squares regression(PLS) model was implemented. Results: The mean Qpv measured in PC-MRI was 0.55 ± 0.12 L/min, and in the TTUS probe was 0.74 ± 0.17 L/min. Qca was 1.40 ± 0.47 L/min in the PC-MRI and 2.00 ± 0.60 L/min in the TTUS probe. Qha was 0.17 ± 0.10 L/min in the PC-MRI, and 0.13 ± 0.06 L/min in the TTUS probe. The Bland-Altman method revealed that the estimated bias of Qca in the PC-MRI was 32%(95% CI:-49% to 15%); Qha 17%(95% CI:-15% to 51%); and Qpv 40%(95% CI:-62% to 18%). The TTUS probe had a higher weight in predicting adverse outcomes after 75% resection compared to the PC-MRI( β= 0.35 and 0.43 vs β = 0.22 and 0.07, for tissue changes and premature death, respectively). Conclusions: There is a tendency of the PC-MRI to underestimate the flow measured by the TTUS probes. The TTUS probe measures are more predictive of relevant post-hepatectomy outcomes.

关键词： Hepatic blood flow Phase contrast MRI Transit time ultrasound probe Porcine model Liver surgery

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