Hepatic magnetic resonance T1-mapping and extracellular volume fraction compared to shear-wave elastography in pediatric Fontan-associated liver disease.

Autor: de Lange C; Division of Radiology and Nuclear Medicine, Section of Paediatric Radiology, Oslo University Hospital, Oslo, Norway. charlotte.de.lange@vgregion.se.; Department of Radiology and Clinical Physiology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Rondv 10, S-41615, Göteborg, Sweden. charlotte.de.lange@vgregion.se., Thrane KJ; Division of Radiology and Nuclear Medicine, Section of Paediatric Radiology, Oslo University Hospital, Oslo, Norway., Thomassen KS; Division of Radiology and Nuclear Medicine, Section of Paediatric Radiology, Oslo University Hospital, Oslo, Norway., Geier O; Department of Physics, Oslo University Hospital, Oslo, Norway., Nguyen B; Division of Radiology and Nuclear Medicine, Section of Paediatric Radiology, Oslo University Hospital, Oslo, Norway., Tomterstad A; Division of Radiology and Nuclear Medicine, Section of Paediatric Radiology, Oslo University Hospital, Oslo, Norway., Ording Müller LS; Division of Radiology and Nuclear Medicine, Section of Paediatric Radiology, Oslo University Hospital, Oslo, Norway., Thaulow E; Department of Paediatric Cardiology, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Almaas R; Department of Paediatric Research and Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway., Døhlen G; Department of Paediatric Cardiology, Oslo University Hospital, Oslo, Norway., Suther KR; Division of Radiology and Nuclear Medicine, Section of Paediatric Radiology, Oslo University Hospital, Oslo, Norway., Möller T; Department of Paediatric Cardiology, Oslo University Hospital, Oslo, Norway.
Jazyk: angličtina
Zdroj: Pediatric radiology [Pediatr Radiol] 2021 Jan; Vol. 51 (1), pp. 66-76. Date of Electronic Publication: 2020 Oct 09.
DOI: 10.1007/s00247-020-04805-y
Abstrakt: Background: Children with Fontan circulation are at risk of developing hepatic fibrosis/cirrhosis. Reliable noninvasive monitoring techniques are lacking or under development.
Objective: To investigate surrogate indicators of hepatic fibrosis in adolescents with Fontan circulation by evaluating hepatic magnetic resonance (MR) T1 mapping and extracellular volume fraction measurements compared to US shear-wave elastography.
Materials and Methods: We analyzed hepatic native T1 times and extracellular volume fractions with modified Look-Locker inversion recovery. Liver stiffness was analyzed with shear-wave elastography. We compared results between 45 pediatric patients ages 16.7±0.6 years with Fontan circulation and 15 healthy controls ages 19.2±1.2 years. Measurements were correlated to clinical and hemodynamic data from cardiac catheterization.
Results: MR mapping was successful in 35/45 patients, revealing higher hepatic T1 times (774±44 ms) than in controls (632±52 ms; P<0.001) and higher extracellular volume fractions (47.4±5.0%) than in controls (34.6±3.8%; P<0.001). Liver stiffness was 1.91±0.13 m/s in patients vs. 1.20±0.10 m/s in controls (P<0.001). Native T1 times correlated with central venous pressures (r=0.5, P=0.007). Native T1 was not correlated with elastography in patients (r=0.2, P=0.1) or controls (r = -0.3, P=0.3). Extracellular volume fraction was correlated with elastography in patients (r=0.5, P=0.005) but not in controls (r=0.2, P=0.6).
Conclusion: Increased hepatic MR relaxometry and shear-wave elastography values in adolescents with Fontan circulation suggested the presence of hepatic fibrosis or congestion. Central venous pressure was related to T1 times. Changes were detected differently with MR relaxometry and elastography; thus, these techniques should not be used interchangeably in monitoring hepatic fibrosis.
Databáze: MEDLINE
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