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Prediction Modelling for Gastroesophageal Variceal Bleeding in Patients With Chronic Hepatitis B Using Four-dimensional Flow MRI.
Dong, Jinghui; Liu, Changchun; Zhang, Mengmeng; Yu, Hailong; Zhao, Di; Bai, Xu; Zheng, Meng; Liu, Yuan; Ji, Jiachen; Li, Rui; Shen, Wen; Cai, Jianming.
Afiliación
  • Dong J; Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
  • Liu C; Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
  • Zhang M; Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
  • Yu H; Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
  • Zhao D; Senior Department of Hepatology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
  • Bai X; Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
  • Zheng M; Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
  • Liu Y; Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
  • Ji J; Department of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua Univercity, Beijing 100084, China.
  • Li R; Department of Biomedical Engineering, Center for Biomedical Imaging Research, Tsinghua Univercity, Beijing 100084, China.
  • Shen W; Department of Radiology, Tianjin First Center Hospital, Tianjin 300192, China.
  • Cai J; Department of Radiology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
J Clin Exp Hepatol ; 15(1): 102403, 2025.
Article en En | MEDLINE | ID: mdl-39296664
ABSTRACT
Background/

Aims:

In this study, we aim to develop a model for predicting gastroesophageal varices (GEV) bleeding in patients with chronic hepatitis B (CHB) by utilizing hemodynamic parameters obtained through four-dimensional flow MRI (4D flow MRI).

Methods:

This study conducted a prospective enrollment of CHB patients suspected of GEV from October 2021 to May 2022. The severity of varices and bleeding risk were evaluated using clinical findings and upper gastrointestinal endoscopy, and patients were classified into high-risk and non-high-risk groups. The study utilized serological examination, ultrasonographic examination, and 4D flow MRI. Relevant parameters were selected through univariate and multivariate analyses, and a prediction model was established using binary logistic regression analysis. The model was combined with the Baveno Ⅵ/Ⅶ and Expanded Baveno Ⅵ/Ⅶ criteria to evaluate diagnostic efficacy and the risk of avoiding endoscopic examination.

Results:

A total of 40 CHB patients were enrolled and categorized into the high-risk group (n = 15) and the non-high-risk group (n = 25). The spleen diameter and regurgitant fraction (R%) were independent predictors of variceal bleeding and a predictive model was established. The combination of this prediction model and the Baveno Ⅵ/Ⅶ criteria achieved high diagnostic efficiency, enabling 45.00% (18/40) of patients to be exempted from the unnecessary endoscopic procedure and the high-risk misclassification rate (0%) was less than 5%.

Conclusion:

The prediction model generated by 4D flow MRI has the potential to assess the likelihood of varices and can be supplemented by the Baveno VI/VII criteria to improve diagnostic accuracy in CHB patients.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Exp Hepatol Año: 2025 Tipo del documento: Article País de afiliación: China Pais de publicación: India

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Exp Hepatol Año: 2025 Tipo del documento: Article País de afiliación: China Pais de publicación: India