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• W2994902230 abstract "Introduction: Chronic atherosclerotic mesenteric ischaemia (CMI) is a serious and increasingly common disorder. The gut has a highly collateralised arterial system and it is often difficult to confidently ascribe abdominal symptoms to chronic ischaemia. Whilst detailed anatomical imaging of the mesenteric arteries is straightforward, there is no proven and reliable functional test of mesenteric perfusion. 4D flow magnetic resonance imaging (MR) holds promise in this regard. The aim of this study was to test the feasibility of this technique. Our key hypothesis was that MR 4D flow would be able to detect functionally important impairment in mesenteric perfusion. Methods: This was a case control pilot study. We studied 5 patients with clinical obvious CMI and 6 healthy controls. We scanned patients at 3T on a Siemens device in the fasted and fed states after a standardised meal. Both 2D and 4D flow data were acquired of both the arterial and venous mesenteric circulation. We explored pre-specified analyses of a variety of parameters at a variety of anatomical sites. We also validated 4D flow quantification. Results: In patients with CMI, there was little to no increase in mesenteric blood flow measured in the portal vein when comparing the fasted and fed states; 10.8 ± 1.6 versus 12.7 ± 0.8 mL/s (p = 0.078). In volunteers, a large increase was apparent; 13.4 ± 3.9 mL/s versus 19.5 ± 4.7 mL/s (p = 0.009). Imaging flow in the arteries was difficult and less reliable, principally due to the presence of disease of the main trunks. There was good agreement between 4D and 2D flow quantification. Conservation of flow in the mesenteric veins was demonstrated, thus providing validation on another level. Conclusion: MR 4D flow can demonstrate an almost total loss of the physiological increase in mesenteric blood flow after a meal. We believe this method may be a valuable way of identifying patients with clinically important mesenteric arterial disease. Based on our data, we estimate that an observational trial of 90 participants divided into 3 arms would be appropriately powered. Disclosure: Nothing to disclose" @default.
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• W2994902230 date "2019-12-01" @default.
• W2994902230 modified "2023-10-17" @default.
• W2994902230 title "Stress Mesenteric Perfusion Imaging Using Magnetic Resonance 4D Flow" @default.
• W2994902230 doi "https://doi.org/10.1016/j.ejvs.2019.09.090" @default.
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