PMID- 36786904 OWN - NLM STAT- MEDLINE DCOM- 20230710 LR - 20231013 IS - 1432-1084 (Electronic) IS - 0938-7994 (Linking) VI - 33 IP - 8 DP - 2023 Aug TI - Assessment of liver fibrosis using a 3-dimensional high-resolution late gadolinium enhancement sequence in children and adolescents with Fontan circulation. PG - 5446-5454 LID - 10.1007/s00330-023-09452-z [doi] AB - OBJECTIVES: To assess abnormal liver enhancement on 15-20 min delayed 3D high-resolution late gadolinium enhancement (3D HR LGE) sequence in patients with Fontan circulation. METHODS: Retrospective study of pediatric Fontan patients (< 18 years old) with combined cardiac-liver MRI from January 2018 to August 2021. Abnormal hepatic enhancement was graded (0-3) for each lobe, summed for a total liver enhancement score (0-6), and compared to repaired tetralogy of Fallot (rTOF) patients. Correlations with other hepatic imaging biomarkers were performed. Temporal relationships of enhancement compared to traditional early portal venous and 5-7-min delayed phase liver imaging were analyzed. RESULTS: The Fontan group (n = 35, 13 +/- 3.4 years old, median time from Fontan 10 (9-12) years) had 23/35 (66%) with delayed 3D HR LGE total liver enhancement score > 0 (range 0-5), with greater involvement of the right lobe (1 (0-1) vs 0 (0-1), p < 0.01). The rTOF group (n = 35, 14 +/- 2.6 years old) had no abnormal enhancement. In the Fontan group, total liver enhancement was 3 (2-4) in the early portal venous phase, lower at 1 (1-2) in the 5-7-min delayed phase (p < 0.01), and lowest at 1 (0-2) in the 15-20-min delayed phase (p = 0.03). 3D HR LGE enhancement correlated inversely with portal vein flow (r(s) = - 0.42, p = 0.01) and positively with left lobe stiffness (r(s) = 0.51, p < 0.01). The enhancement score decreased in 13/35 (37%) between the 5-7- and 15-20-min delayed phases. CONCLUSIONS: Liver fibrosis can be assessed on 3D HR LGE sequences in patients with Fontan circulation, correlates with other imaging biomarkers of Fontan liver disease, and may add information for hepatic surveillance in this population. KEY POINTS: * Abnormal liver enhancement on 3D HR LGE sequences in Fontan patients likely represents liver fibrosis and is seen in up to 66% of children and adolescents with variable distribution and severity. * The degree of 3D HR LGE liver enhancement correlates with decreased portal vein flow and increased left hepatic lobe stiffness. CI - (c) 2023. The Author(s), under exclusive licence to European Society of Radiology. FAU - Acosta Izquierdo, Laura AU - Acosta Izquierdo L AD - Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada. AD - Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. FAU - Rai, Archana AU - Rai A AD - Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada. AD - Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. FAU - Saprungruang, Ankavipar AU - Saprungruang A AD - Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada. AD - Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. FAU - Chavhan, Govind B AU - Chavhan GB AD - Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada. AD - Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. FAU - Kamath, Binita M AU - Kamath BM AD - Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. FAU - Dipchand, Anne I AU - Dipchand AI AD - Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. FAU - Seed, Mike AU - Seed M AD - Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada. AD - Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. AD - Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. FAU - Yoo, Shi-Joon AU - Yoo SJ AD - Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada. AD - Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. FAU - Lam, Christopher Z AU - Lam CZ AUID- ORCID: 0000-0002-4605-5600 AD - Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada. christopher.lam@sickkids.ca. AD - Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. christopher.lam@sickkids.ca. LA - eng PT - Journal Article DEP - 20230214 PL - Germany TA - Eur Radiol JT - European radiology JID - 9114774 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) RN - 0 (Biomarkers) SB - IM EIN - Eur Radiol. 2023 Jun 26;:. PMID: 37358614 MH - Humans MH - Child MH - Adolescent MH - *Fontan Procedure MH - Contrast Media MH - Gadolinium MH - Retrospective Studies MH - Liver Cirrhosis/diagnostic imaging MH - *Tetralogy of Fallot/diagnostic imaging/surgery MH - Magnetic Resonance Imaging/methods MH - Biomarkers OTO - NOTNLM OT - Fontan procedure OT - Liver cirrhosis OT - Liver diseases OT - Magnetic resonance imaging OT - Univentricular heart EDAT- 2023/02/15 06:00 MHDA- 2023/07/10 06:42 CRDT- 2023/02/14 11:17 PHST- 2022/08/06 00:00 [received] PHST- 2023/02/03 00:00 [accepted] PHST- 2022/12/05 00:00 [revised] PHST- 2023/07/10 06:42 [medline] PHST- 2023/02/15 06:00 [pubmed] PHST- 2023/02/14 11:17 [entrez] AID - 10.1007/s00330-023-09452-z [pii] AID - 10.1007/s00330-023-09452-z [doi] PST - ppublish SO - Eur Radiol. 2023 Aug;33(8):5446-5454. doi: 10.1007/s00330-023-09452-z. Epub 2023 Feb 14.