Quantifying and visualizing abdominal hemodynamics in patients with Fontan circulation by 4D phase-contrast flow magnetic resonance imaging at 1.5 T.

Autor: Salehi Ravesh M; University Hospital of Schleswig-Holstein, Campus Kiel, Department of Radiology and Neuroradiology, Germany., Langguth P; University Hospital of Schleswig-Holstein, Campus Kiel, Department of Radiology and Neuroradiology, Germany., Moritz JD; University Hospital of Schleswig-Holstein, Campus Kiel, Department of Radiology and Neuroradiology, Germany., Rinne K; University Hospital of Schleswig-Holstein, Campus Kiel, Department of Congenital Heart Disease and Pediatric Cardiology, Germany., Harneit PL; University Hospital of Schleswig-Holstein, Campus Kiel, Department of Congenital Heart Disease and Pediatric Cardiology, Germany., Schulze-Nagel J; University Hospital of Schleswig-Holstein, Campus Kiel, Department of Congenital Heart Disease and Pediatric Cardiology, Germany., Graessner J; Siemens Healthcare GmbH, Hamburg, Germany., Uebing A; University Hospital of Schleswig-Holstein, Campus Kiel, Department of Congenital Heart Disease and Pediatric Cardiology, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Germany., Jansen O; University Hospital of Schleswig-Holstein, Campus Kiel, Department of Radiology and Neuroradiology, Germany., Both M; University Hospital of Schleswig-Holstein, Campus Kiel, Department of Radiology and Neuroradiology, Germany., Hansen JH; University Hospital of Schleswig-Holstein, Campus Kiel, Department of Congenital Heart Disease and Pediatric Cardiology, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Germany. Electronic address: janhinnerk.hansen@uksh.de.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2024 Oct 15; Vol. 413, pp. 132391. Date of Electronic Publication: 2024 Jul 25.
DOI: 10.1016/j.ijcard.2024.132391
Abstrakt: Background: Liver fibrosis has been recognized as a long-term morbidity associated with Fontan circulation (Fontan-associated liver disease, FALD). The pathophysiology of FALD is not completely understood and abnormal flow dynamics may be associated with this condition. Liver hemodynamics can be quantitatively evaluated with four-dimensional phase-contrast flow magnetic resonance imaging (4D PC flow MRI). The study aimed to evaluate suitability of liver 4D PC flow MRI in Fontan patients and relate flow measurements to normal values and FALD severity.
Patients and Methods: Twenty-two Fontan patients were examined by 4D PC flow MRI at 1.5 Tesla to assess mesenteric, portal, splenic, and hepatic venous blood flow. Severity of FALD was graded based on routine screening, including abdominal ultrasound and laboratory tests.
Results: Median age was 18.5 (interquartile range, IQR 15.5-20.2) years. FALD was graded as "none or mild" in 16 and as "moderate to severe" in six cases. Ten patients presented at least one feature of portal hypertension (ascites, splenomegaly, or thrombocytopenia). For the entire cohort, blood flow in the superior mesenteric, splenic, and portal vein was lower than reported in the literature. No significant differences were observed in relation to FALD severity. Features of portal hypertension were associated with a higher splenic vein blood flow (0.34 ± 0.17 vs. 0.20 ± 0.07 l/min, p = 0.046). Splenic vein blood flow was negatively correlated to platelet count (r = -0.590, p = 0.005).
Conclusions: 4D PC flow MRI appears suitable to assess liver hemodynamics in Fontan patients and integration into clinical follow-up might help to improve our understanding of FALD.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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