Preeti Ramachandran1, Suraj D Serai2, Gruschen R Veldtman3, Sean M Lang3, Wojciech Mazur4, Andrew T Trout5, Jonathan R Dillman5, Robert J Fleck5, Michael D Taylor6, Tarek Alsaied3, Ryan A Moore3. 1. Division of Pediatric Cardiology, University of Kentucky, Lexington, KY, 40506, USA. 2. Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA. serais@email.chop.edu. 3. Pediatric Cardiology, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA. 4. Department of Cardiology, The Christ Hospital, 2123 Auburn Ave, Cincinnati, OH, 45219, USA. 5. Department of Radiology, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA. 6. Pediatric Cardiology, Children's Healthcare of Atlanta, 1405 Clifton Rd. NE, Atlanta, GA, 30322, USA.
Abstract
OBJECTIVES: To explore the utility of liver T1 mapping in Fontan patients and its correlation to magnetic resonance elastography (MRE)-derived liver stiffness. BACKGROUND AND AIMS: Liver disease is a major long-term extra cardiac complication in the Fontan population. MRE is frequently used to quantify liver stiffness in Fontan patients; however, it has certain limitations. Native T1 mapping by cardiac magnetic resonance (CMR) is useful in assessment of cardiac fibrosis, but its potential in evaluating liver fibrosis and its correlation to MRE-derived liver stiffness in Fontan patients have not been reported. METHODS: Fontan patients who underwent CMR and MRE were included. Liver Native T1, extracellular volume (ECV) and delta coefficients were measured and correlated with MRE-derived liver stiffness in all Fontan patients. Native liver T1 in Fontan patients were compared to normal controls with biventricular circulation and no known liver disease. RESULTS: A total of 17 Fontan patients and 7 normal controls were included in this study. Fontan patients had significantly higher liver native T1 (690 ± 41 ms vs 620 ± 35 ms; p < 0.001) as compared to controls. There was strong positive correlation between MRE derived liver stiffness and liver native T1 (r = 0.81, p < 0.001). CONCLUSIONS: Liver native T1 was significantly elevated in Fontan patients compared to controls and strongly correlated with MRE-derived liver stiffness. This technique may prove to be a useful noninvasive imaging biomarker for assessing liver fibrosis in the Fontan population.
OBJECTIVES: To explore the utility of liver T1 mapping in Fontan patients and its correlation to magnetic resonance elastography (MRE)-derived liver stiffness. BACKGROUND AND AIMS: Liver disease is a major long-term extra cardiac complication in the Fontan population. MRE is frequently used to quantify liver stiffness in Fontan patients; however, it has certain limitations. Native T1 mapping by cardiac magnetic resonance (CMR) is useful in assessment of cardiac fibrosis, but its potential in evaluating liver fibrosis and its correlation to MRE-derived liver stiffness in Fontan patients have not been reported. METHODS: Fontan patients who underwent CMR and MRE were included. Liver Native T1, extracellular volume (ECV) and delta coefficients were measured and correlated with MRE-derived liver stiffness in all Fontan patients. Native liver T1 in Fontan patients were compared to normal controls with biventricular circulation and no known liver disease. RESULTS: A total of 17 Fontan patients and 7 normal controls were included in this study. Fontan patients had significantly higher liver native T1 (690 ± 41 ms vs 620 ± 35 ms; p < 0.001) as compared to controls. There was strong positive correlation between MRE derived liver stiffness and liver native T1 (r = 0.81, p < 0.001). CONCLUSIONS: Liver native T1 was significantly elevated in Fontan patients compared to controls and strongly correlated with MRE-derived liver stiffness. This technique may prove to be a useful noninvasive imaging biomarker for assessing liver fibrosis in the Fontan population.
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