[4D Flow-MRI for Predicting Residual Liver Volume after Portal Vein Embolization in a Patient with Recurrent Liver Metastasis and Renal Impairment].

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Tác giả: Shunji Endo, Yoshinori Fujiwara, Yoshihiko Fukukura, Kei Furuya, Atsushi Higaki, Masaharu Higashida, Takahiro Inoue, Hironobu Kanbara, Shuji Kitagawa, Shumei Mineta, Toshimasa Okada, Michi Ueno, Tomio Ueno, Shuya Yano, Kazuhiko Yoshimatsu

Ngôn ngữ: eng

Ký hiệu phân loại: 615.367 Liver extracts

Thông tin xuất bản: Japan : Gan to kagaku ryoho. Cancer & chemotherapy , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 168000

A male in his 70s underwent laparoscopic-assisted high anterior resection and D2 lymph node dissection for rectal cancer (pT3, pN1a, M0, fStage ⅢB)3 years ago. Postoperative adjuvant chemotherapy was not administered due to diabetic nephropathy. Three years post-surgery, plain CT and PET-CT revealed recurrent liver metastasis at the bifurcation of the anterior and posterior liver segments. Right hepatic lobectomy was planned following portal vein embolization, as his ICG R15 was 18.9%, indicating insufficient residual liver volume after resection. To avoid frequent contrast-enhanced CT scans due to low renal function, 4D flow-MRI was performed before portal vein embolization and on the third day post-embolization to measure portal blood flow velocity and volume. These measurements were applied to the estimated residual liver volume formula to predict the residual liver volume 28 days later. The predicted residual liver volume on the 28th day was 469 mL(64%), and CT volumetry performed on the same day showed a volume of 471 mL. Right hepatic lobectomy was performed without worsening liver or kidney function. This case report demonstrates that using 4D flow-MRI can accurately predict the residual liver volume after portal vein embolization, enabling safe curative resection in patients for whom contrast-enhanced CT is challenging due to renal impairment.
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