OBJECTIVE: The purpose of this study was to evaluate the feasibility of performing magnetic resonance elastography (MRE) as a screening tool for elevated liver stiffness in patients' status-post Fontan procedure. BACKGROUND: With greater numbers of Fontan patients surviving far into adulthood, a factor increasingly affecting long-term prognosis is the presence of hepatic congestion and fibrosis. If detected early, steps can be taken to potentially slow or halt the progression of fibrosis. MRE is a relatively new, noninvasive imaging technique, which can quantitatively measure liver stiffness and provide an estimate of the extent of fibrosis. METHODS: A retrospective study was conducted using MRE to evaluate liver stiffness in patients with a history of Fontan procedure. An MRE was performed in the same session as a clinical cardiac MRI. The liver was interrogated at four slice locations, and a mean liver stiffness value was calculated for each patient using postprocessing software. The medical records were reviewed for demographic and clinical characteristics. RESULTS: During the time frame of this investigation, 17 MRE exams were performed on 16 patients. All patients had elevated liver stiffness values as defined by MRE standards. The median of the individual mean liver stiffness values was 5.1 kPa (range: 3.4-8.2 kPa). This range of liver stiffness elevation would suggest the presence of mild to severe fibrosis in a patient with standard cardiovascular anatomy. We found a significant trend toward higher liver stiffness values with greater duration of Fontan circulation (rs = 0.55, P = .02). CONCLUSION: Our preliminary findings suggest that MRE is a feasible method for evaluating the liver in Fontan patients who are undergoing surveillance cardiac MRI. Further investigation with histologic correlation is needed to determine the contributions of hepatic congestion and fibrosis to the liver stiffness in this population.
OBJECTIVE: The purpose of this study was to evaluate the feasibility of performing magnetic resonance elastography (MRE) as a screening tool for elevated liver stiffness in patients' status-post Fontan procedure. BACKGROUND: With greater numbers of Fontan patients surviving far into adulthood, a factor increasingly affecting long-term prognosis is the presence of hepatic congestion and fibrosis. If detected early, steps can be taken to potentially slow or halt the progression of fibrosis. MRE is a relatively new, noninvasive imaging technique, which can quantitatively measure liver stiffness and provide an estimate of the extent of fibrosis. METHODS: A retrospective study was conducted using MRE to evaluate liver stiffness in patients with a history of Fontan procedure. An MRE was performed in the same session as a clinical cardiac MRI. The liver was interrogated at four slice locations, and a mean liver stiffness value was calculated for each patient using postprocessing software. The medical records were reviewed for demographic and clinical characteristics. RESULTS: During the time frame of this investigation, 17 MRE exams were performed on 16 patients. All patients had elevated liver stiffness values as defined by MRE standards. The median of the individual mean liver stiffness values was 5.1 kPa (range: 3.4-8.2 kPa). This range of liver stiffness elevation would suggest the presence of mild to severe fibrosis in a patient with standard cardiovascular anatomy. We found a significant trend toward higher liver stiffness values with greater duration of Fontan circulation (rs = 0.55, P = .02). CONCLUSION: Our preliminary findings suggest that MRE is a feasible method for evaluating the liver in Fontan patients who are undergoing surveillance cardiac MRI. Further investigation with histologic correlation is needed to determine the contributions of hepatic congestion and fibrosis to the liver stiffness in this population.
Authors: Paul Khairy; Susan M Fernandes; John E Mayer; John K Triedman; Edward P Walsh; James E Lock; Michael J Landzberg Journal: Circulation Date: 2007-12-10 Impact factor: 29.690
Authors: Meng Yin; Jayant A Talwalkar; Kevin J Glaser; Armando Manduca; Roger C Grimm; Phillip J Rossman; Jeff L Fidler; Richard L Ehman Journal: Clin Gastroenterol Hepatol Date: 2007-10 Impact factor: 11.382
Authors: James S Tweddell; Nancy S Ghanayem; Kathleen A Mussatto; Michael E Mitchell; Luke J Lamers; Ndidiamaka L Musa; Stuart Berger; S Bert Litwin; George M Hoffman Journal: Ann Thorac Surg Date: 2007-10 Impact factor: 4.330
Authors: Meng Yin; John Woollard; Xiaofang Wang; Vicente E Torres; Peter C Harris; Christopher J Ward; Kevin J Glaser; Armando Manduca; Richard L Ehman Journal: Magn Reson Med Date: 2007-08 Impact factor: 4.668
Authors: Laurent Huwart; Frank Peeters; Ralph Sinkus; Laurence Annet; Najat Salameh; Leon C ter Beek; Yves Horsmans; Bernard E Van Beers Journal: NMR Biomed Date: 2006-04 Impact factor: 4.044
Authors: Abhay Srinivasan; Anthony K Guzman; Elizabeth B Rand; Jack Rychik; David J Goldberg; Pierre A Russo; Anne Marie Cahill Journal: Pediatr Radiol Date: 2018-11-30
Authors: Suraj D Serai; Nancy A Obuchowski; Sudhakar K Venkatesh; Claude B Sirlin; Frank H Miller; Edward Ashton; Patricia E Cole; Richard L Ehman Journal: Radiology Date: 2017-05-22 Impact factor: 11.105
Authors: Juan S Calle-Toro; Suraj D Serai; Erum A Hartung; David J Goldberg; Bradley D Bolster; Kassa Darge; Sudha A Anupindi Journal: Abdom Radiol (NY) Date: 2019-03
Authors: Chun Yang; Meng Yin; Kevin J Glaser; Xiangyang Zhu; Kai Xu; Richard L Ehman; Jun Chen Journal: Magn Reson Imaging Date: 2017-09-01 Impact factor: 2.546
Authors: Frank W DiPaola; Kurt R Schumacher; Caren S Goldberg; Joshua Friedland-Little; Aishwarya Parameswaran; Jonathan R Dillman Journal: Eur Radiol Date: 2016-10-17 Impact factor: 5.315