Regional Elevation of Liver T1 in Fontan Patients

Overview

Journal CJC Pediatr Congenit Heart Dis

Specialty Cardiology & Vascular Diseases

Date 2023 Nov 16

PMID 37969352

Authors

Paul G Greidanus

Joseph J Pagano

Carolina A Escudero

Richard Thompson

Edythe B Tham

Affiliations

Soon will be listed here.

Abstract

Background: Fontan-associated liver disease (FALD) is characterized by hepatic congestion and progressive hepatic fibrosis in patients with the Fontan operation. This condition is generally clinically silent until late, necessitating techniques for early detection. Liver T1 mapping has been used to screen for FALD, but without consideration of regional variations in T1 values.

Methods: Liver T1 measured with a liver-specific T1 mapping sequence (PROFIT1) in Fontan patients was compared with cohorts of patients with biventricular congenital heart disease (BiV-CHD) and controls with normal cardiac function and anatomy.

Results: Liver T1 was significantly elevated in the Fontan cohort (n = 20) compared with patients with BiV-CHD (n = 12) and controls (n = 9) (781, 678, and 675 milliseconds, respectively; < 0.001), with a consistent pattern of significantly elevated T1 values in the peripheral compared with central liver regions (ΔT1 = 54, 2, and 11 milliseconds; < 0.001). PROFIT1 also yielded simultaneous T2∗ maps and fat fraction values that were similar in all groups. Fontan liver T1 values were also significantly elevated as compared with BiV-CHD and controls as measured with the cardiac (modified Look-Locker inversion) acquisitions (728, 583, and 583 milliseconds, respectively; < 0.001) and values correlated with PROFIT1 liver T1 (R = 0.87, < 0.001).

Conclusions: Fontan patients have globally increased liver T1 values and consistent spatial variations, with higher values in the peripheral liver regions as compared with spatially uniform values in BiV-CHD and controls. The spatial patterns may provide insight into the progression of FALD. Liver T1 mapping studies should include uniform spatial coverage to avoid bias based on slice locations in this population.

Citing Articles

Liver T1 mapping in Fontan patients and patients with biventricular congenital heart disease - insights into the effects of venous congestions on diffuse liver disease.

Ide Y, Gabbert D, Hansen J, Uebing A, Voges I Int J Cardiovasc Imaging. 2025; 41(2):347-358.

PMID: 39776323 PMC: 11811443. DOI: 10.1007/s10554-024-03314-5.

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