Assessment of liver T1 mapping in fontan patients and its correlation with magnetic resonance elastography-derived liver stiffness

Ramachandran, P; Serai, Suraj D.; Veldtman, Gruschen; Lang, Sean M.; Mazur, Wojciech; Trout, Andrew T.; Dillman, Jonathan R.; Fleck, Robert; Taylor, Michael D.; Alsaied, Tarek; Moore, Ryan

doi:10.1007/s00261-019-01990-9

Cited by 39 publications

(28 citation statements)

References 29 publications

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“…The elevated hepatic T1, extracellular volume fraction, and elastography values confirmed previous findings from retrospective MR studies in adults and children with Fontan [18,21,22] and studies on US and MR elastography after Fontan completion [19,20,27,28]. The advantage of our study was the representative, unselected, relatively large national cohort of adolescents with Fontan circulation.…”

Section: Discussionsupporting

confidence: 87%

“…This correlation strengthened with increasing histological stage severity [ 29 ]. Conversely, Ramachandran et al [ 21 ] studied MR elastography in adults with Fontan circulation and reported that native T1 strongly correlated with MR elastography but not with extracellular volume fraction. Despite the homogeneous age of the patient group in our study, liver tissue changes were heterogeneous.…”

Section: Discussionmentioning

confidence: 99%

“…US shear-wave elastography is simpler and less resource-demanding than MR, and is routinely used to assess adult chronic liver disease [16,17]. Few studies have employed hepatic MR T1 mapping or elastography to evaluate fibrosis or congestion in people with Fontan circulation [18][19][20][21][22]. We hypothesized that adolescents with Fontan circulation might display elevations in fibrosis markers, based on MR T1 mapping, extracellular volume fraction, and US shear-wave elastography.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…Histopathological studies show correlations between hepatic T1, T2, and ECV with liver fibrosis, as well as hepatic ECV and portal pressure in both animal and human models [8,13,14,[21][22][23]. There are also studies mentioning positive correlations between mapping parameters and magnetic resonance elastography (MRE) [22,24,25].…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance parametric mapping of the spleen for non-invasive assessment of portal hypertension

et al. 2020

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Objectives In patients with advanced liver disease, portal hypertension is an important risk factor, leading to complications such as esophageal variceal bleeding, ascites, and hepatic encephalopathy. This study aimed to determine the diagnostic value of T1 and T2 mapping and extracellular volume fraction (ECV) for the non-invasive assessment of portal hypertension. Methods In this prospective study, 50 participants (33 patients with indication for trans-jugular intrahepatic portosystemic shunt (TIPS) and 17 healthy volunteers) underwent MRI. The derivation and validation cohorts included 40 and 10 participants, respectively. T1 and T2 relaxation times and ECV of the liver and the spleen were assessed using quantitative mapping techniques. Direct hepatic venous pressure gradient (HVPG) and portal pressure measurements were performed during TIPS procedure. ROC analysis was performed to compare diagnostic performance. Results Splenic ECV correlated with portal pressure (r = 0.72; p < 0.001) and direct HVPG (r = 0.50; p = 0.003). No significant correlations were found between native splenic T1 and T2 relaxation times with portal pressure measurements (p > 0.05, respectively). In the derivation cohort, splenic ECV revealed a perfect diagnostic performance with an AUC of 1.000 for the identification of clinically significant portal hypertension (direct HVPG ≥ 10 mmHg) and outperformed other parameters: hepatic T2 (AUC, 0.731), splenic T2 (AUC, 0.736), and splenic native T1 (AUC, 0.806) (p < 0.05, respectively). The diagnostic performance of mapping parameters was comparable in the validation cohort. Conclusion Splenic ECV was associated with portal pressure measurements in patients with advanced liver disease. Future studies should explore the diagnostic value of parametric mapping accross a broader range of pressure values. Key Points • Non-invasive assessment and monitoring of portal hypertension is an area of unmet interest. • Splenic extracellular volume fraction is strongly associated with portal pressure in patients with end-stage liver disease. • Quantitative splenic and hepatic MRI-derived parameters have a potential to become a new non-invasive diagnostic parameter to assess and monitor portal pressure.

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“…Double contrast-enhanced MRI using gadolinium-based CAs and SPIOs with or without texture analysis has been used to differentiate early liver fibrosis from advanced disease with excellent results [23,54,55]. Collagen fiber deposition in the space of Disse leads to an increase of the extracellular space quantifiable as the distribution volume fraction of nonspecific CA in the parenchymal (equilibrium) phase by MRI (or CT) [56][57][58][59]. Preclinical studies have shown that the liver accumulation of collagen targeted CAs correlates with histological fibrosis scores [60].…”

Section: Mrementioning

confidence: 99%

Clinical and Preclinical Imaging of Hepatosplenic Schistosomiasis

Masi

Perles-Barbacaru

Bernard

et al. 2020

Trends in Parasitology

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Schistosomiasis, a neglected tropical disease, is a major cause of chronic morbidity and disability, and premature death. The hepatosplenic form of schistosomiasis is characterized by hepatosplenomegaly, liver fibrosis, portal hypertension and oesophageal varices, whose rupture may cause bleeding and death. We review currently available abdominal imaging modalities and describe their basic principles, strengths, weaknesses, and usefulness in the assessment of hepatosplenic schistosomiasis. Advanced imaging methods are presented that could be of interest for hepatosplenic schistosomiasis evaluation by yielding morphological, functional and molecular parameters of disease progression. We also provide a comprehensive view of preclinical imaging studies and current research objectives such as parasite visualisation in hosts, follow-up of host-immune response, and development of non-invasive quantitative methods for liver fibrosis assessment.

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Assessment of liver T1 mapping in fontan patients and its correlation with magnetic resonance elastography-derived liver stiffness

Cited by 39 publications

References 29 publications

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

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

Magnetic resonance parametric mapping of the spleen for non-invasive assessment of portal hypertension

Clinical and Preclinical Imaging of Hepatosplenic Schistosomiasis

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