MRI assessment of altered dynamic changes in liver haemodynamics following a meal challenge in compensated cirrhosis

BACKGROUND: The aim was to use magnetic resonance imaging (MRI) to dynamically assess postprandial changes in hepatic and collateral blood flow, liver perfusion and oxygenation in healthy participants and patients with liver disease with compensated cirrhosis (CC). METHODS: We evaluated blood flow in the portal vein, hepatic artery and azygos vein (using phase-contrast MRI), liver perfusion (using arterial spin labelling) and blood oxygenation (using transverse relaxation time [T2*] mapping). Measures were collected at baseline and at 6–7-min intervals from 20 to 65 min following a test meal (440 mL, 660 kcal) in 10 healthy participants and 10 patients with CC. RESULTS: In healthy participants, we observed a significant postprandial increase in portal vein flow from baseline (+ 137 ± 26% (mean ± standard deviation), p < 0.001) coupled with a reduction in hepatic artery flow from baseline (− 30 ± 18%, p = 0.008), reflecting the hepatic artery buffer response. In patients with CC, a lower but still significant increase in portal vein flow (67 ± 50%, p = 0.014) was observed, without a clear hepatic artery buffer response. Healthy participants showed a significant increase in postprandial liver perfusion (138 ± 75%, p < 0.001), not observed in patients with CC. There was no change in liver T2* for either group. CONCLUSIONS: Postprandial changes in liver perfusion, oxygenation and hepatic and collateral circulation can be measured noninvasively using MRI. Differences between healthy participants and patients with CC were shown, which may help stratify liver cirrhosis in patients.