Magnetic Resonance Elastography: A Novel Technique for Detection of Hepatic Cirrhosis and Hepatocellular Carcinoma After the Fontan Operation

Poterucha, Joseph T.; Johnson, Jonathan N.; Bonnichsen, Crystal R.; Sf, Phillips; Kamath, Patrick S.; Young, Phillip M.; Venkatesh, Sudhakar K.; Warnes, Carole A.; Cetta, Frank

doi:10.1016/s0735-1097(14)60477-0

Cited by 45 publications

(108 citation statements)

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“…Finally, 31 studies fulfilled the eligibility criteria for our analysis, including eight studies using both GRE and SE‐EPI sequences, 22 studies using only a GRE sequence, , , , , , , , and one study using only an SE‐EPI sequence . As one study using both GRE and SE‐EPI sequences potentially overlapped with a population in another GRE sequence outcome study, we did not include the outcomes of this study in the evaluation of the pooled proportion of technical failure of GRE sequences, but used it only for the head‐to‐head comparison between GRE and SE‐EPI sequences.…”

Section: Resultsmentioning

confidence: 99%

“…Nonetheless, as people tend to focus more on successful results rather than technical failure when presenting the results of studies, the failure rates of MRE have not been reported well. A limited number of studies have reported on the technical failure rate of MRE, and fewer studies have made comparisons regarding the failure rates between these two sequences. The results from the studies are also limited by their small sample sizes and the resulting low levels of evidence.…”

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confidence: 99%

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Comparison of technical failure of MR elastography for measuring liver stiffness between gradient‐recalled echo and spin‐echo echo‐planar imaging: A systematic review and meta‐analysis

Kim

Yoon

et al. 2019

Magnetic Resonance Imaging

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Background Magnetic resonance elastography (MRE) using a gradient‐recalled echo (GRE) or a recently available spin‐echo echo‐planar imaging (SE‐EPI) sequence is a promising noninvasive method for measuring liver stiffness. However, it sometimes fails to measure stiffness values, thereby resulting in technical failures. Purpose To assess and compare technical failures of MRE for measuring liver stiffness between GRE and SE‐EPI sequences. Study Type Systematic review and meta‐analysis. Population Eight studies with both GRE and SE‐EPI, 22 studies with only GRE, one study with only SE‐EPI. Field Strength/Sequence Either 1.5 or 3T MRE using GRE and/or SE‐EPI. Assessment Through an Ovid‐MEDLINE and EMBASE database search, original articles investigating the proportion of MRE technical failures in the measurement of liver stiffness published up until October 2018 were screened and selected. Statistical Analysis The pooled proportions of technical failures under GRE and SE‐EPI were calculated using random‐effects meta‐analysis of single proportions and inverse variance for calculating weights. Subgroup analyses were performed to explore the covariates affecting heterogeneity. Head‐to‐head comparisons of technical failure between the sequences were conducted with eight MRE studies using both GRE and SE‐EPI. Results The pooled proportion of technical failure under GRE MRE was 5.8% (95% confidence interval [CI], 4.6–7.4%), and a subgroup analysis showed higher technical failure rates at 3T than at 1.5T. The pooled proportion of technical failure under SE‐EPI MRE was 2.0% (95% CI, 1.3–3.4%), without significant differences (P = 0.38–0.89) being observed in the subgroup analyses. In the eight studies comparing the two sequences, failure was more frequently observed with GRE than with SE‐EPI (9.4% vs. 1.9%; P < 0.01). Data Conclusion MRE conducted with SE‐EPI sequences showed a lower technical failure rate than GRE sequences. With GRE sequences, a magnetic field of 3T was associated with higher technical failure rates than was 1.5T. Level of Evidence: 1 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;51:1086–1102.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Comparison of technical failure of MR elastography for measuring liver stiffness between gradient‐recalled echo and spin‐echo echo‐planar imaging: A systematic review and meta‐analysis

Kim

Yoon

et al. 2019

Magnetic Resonance Imaging

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“…However, these measurements likely overestimate the degree of liver fibrosis caused by hepatic congestion. [137][138][139] Thus, there is insufficient evidence to recommend routine elastography for surveillance of liver disease in the management of patients with CHD.…”

Section: Managementmentioning

confidence: 99%

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lui¹,

Saïdi²,

Bhatt³

et al. 2017

Circulation

180

136

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ABSTRACT:Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention.

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“…Progressive hepatic cirrhosis is a risk factor for the development of hepatocellular carcinoma, gastrointestinal bleeding, hepatic failure, and hepatic encephalopathy, and may be a contraindication to heart transplantation [22][23][24][25]. In a small series of asymptomatic patients a mean of 16 years post-Fontan, a liver biopsy was performed during cardiac catheterization and hepatic fibrosis was present in 18/21 (85%) patients.…”

Section: Hepatic Fibrosis and Cirrhosismentioning

confidence: 99%

“…In the symptomatic patient, abnormalities in the transaminases and platelet count may be present, but are not sensitive predictors of the degree of fibrosis [27]. The quantification of liver stiffness by transient elastography, supersonic shear imaging, or magnetic resonance (MR) elastography as a measure of the degree of fibrosis holds some promise, but these techniques have not been widely adopted as screening tools [23,[28][29][30][31].…”

Section: Hepatic Fibrosis and Cirrhosismentioning

confidence: 99%

The Fontan operation

Hsu

2015

Current Opinion in Pediatrics

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Magnetic Resonance Elastography: A Novel Technique for Detection of Hepatic Cirrhosis and Hepatocellular Carcinoma After the Fontan Operation

Cited by 45 publications

References 0 publications

Comparison of technical failure of MR elastography for measuring liver stiffness between gradient‐recalled echo and spin‐echo echo‐planar imaging: A systematic review and meta‐analysis

Comparison of technical failure of MR elastography for measuring liver stiffness between gradient‐recalled echo and spin‐echo echo‐planar imaging: A systematic review and meta‐analysis

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

The Fontan operation

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