Liver fibrosis detected by diffusion-weighted magnetic resonance imaging and its functional correlates in Fontan patients

Author:

Lu Chun-Wei12ORCID,Wu Chih-Horng3,Huang Miao-Tzu4ORCID,Lee Chee-Seng5,Chen Huey-Ling2,Lin Ming-Tai2,Chiu Shuenn-Nan2,Tseng Wei-Chieh2,Chen Chun-An2ORCID,Wang Jou-Kou2ORCID,Wu Mei-Hwan12

Affiliation:

1. Adult Congenital Heart Center, National Taiwan University Hospital , Taipei, Taiwan

2. Department of Pediatrics, National Taiwan University Hospital , Taipei, Taiwan

3. Department of Medical Imaging, National Taiwan University Hospital , Taipei, Taiwan

4. Department of Medical Research, National Taiwan University Hospital , Taipei, Taiwan

5. Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Biomedical Park Branch , Hsin-Chu, Taiwan

Abstract

Abstract OBJECTIVES The evaluation of Fontan-associated liver disease is often challenging. Diffusion-weighted magnetic resonance imaging can detect hepatic fibrosis from capillary perfusion and diffusion abnormalities from extracellular matrix accumulation. This study investigated its role in the evaluation of liver disease in Fontan patients and explored possible diagnostic methods for early detection of advanced liver fibrosis. METHODS Stable adult Fontan patients who could safely be examined with magnetic resonance imaging were enrolled, and blood biomarkers, transient elastography were also examined. RESULTS Forty-six patients received diffusion-weighted imaging; and 58.7% were diagnosed with advanced liver fibrosis (severe liver fibrosis, 37.0%, and cirrhosis 21.7%). Two parameters of hepatic dysfunction, platelet counts (Spearman’s ρ: –0.456, P = 0.001) and cholesterol levels (Spearman’s ρ: –0.383, P = 0.009), decreased with increasing severity of fibrosis. Using transient elastography, a cut-off value of 14.2 kPa predicted the presence of advanced liver fibrosis, but with a low positive predictive value. When we included platelet count, cholesterol, post-Fontan years and transient elastography values as a composite, the capability of predicting advanced liver fibrosis was the most satisfactory (C statistic 0.817 ± 0.071, P < 0.001). A cut-off value of 5.0 revealed a sensitivity of 78% and a specificity of 82%. CONCLUSIONS In Fontan patients, diffusion-weighted imaging was helpful in detecting liver fibrosis that was correlated with hepatic dysfunction. A simple score was proposed for long-term surveillance and early detection of advanced liver disease in adult Fontan patients. For adult Fontan patients with a calculated score > 5.0, we may consider timely diffusion-weight imaging and early management for liver complications.

Funder

National Taiwan University Hospital

Ministry of Science and Technology

Publisher

Oxford University Press (OUP)

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3