Liver fibrosis detected by diffusion-weighted magnetic resonance imaging and its functional correlates in Fontan patients.
Journal
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
Journal Volume
66
Journal Issue
1
ISSN
1873-734X
Date Issued
2024-07-01
Author(s)
Huang, Miao-Tzu
Lee, Chee-Seng
Chen, Huey-Ling
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 5.0, we may consider timely diffusion-weight imaging and early management for liver complications.
Subjects
Cholesterol
Diffusion-weighted magnetic resonance imaging
Fontan operation
Fontan-associated liver disease
Platelet count
SDGs
Type
journal article