Magnetic Resonance Elastography: A Novel Technique for the Detection of Hepatic XXXX After the Fontan Operation.

@entity1 @entity82 @entity409 @entity1011 @entity1575 @entity157 @entity99
OBJECTIVE: To evaluate the utility of magnetic resonance elastography (MRE) in screening @entity1 for @entity1575 , @entity82 , and @entity157 after the Fontan operation. @entity1 AND METHODS: Hepatic MRE was performed in conjunction with cardiac magnetic resonance imaging in @entity1 who had undergone a Fontan operation between 2010 and 2014. @entity409 was calculated using previously reported techniques. Comparisons to available clinical, laboratory, imaging, and histopathologic data were made. RESULTS: Overall, 50 @entity1 at a median age of 25 years (range, 21-33 years) who had undergone a Fontan operation were evaluated. The median interval between Fontan operation and MRE was 22 years (range, 16-26 years). The mean liver stiffness values were increased: 5.5  1.4 kPa relative to normal @entity1 . @entity409 directly correlated with liver biopsy-derived total @entity82 score, time since operation, mean Fontan pressure, y-glutamyltransferase level, Model for End-Stage @entity409 score, @entity1011 level, and pulmonary vascular resistance index. @entity409 was inversely correlated with cardiac index. All 3 @entity1 with hepatic nodules exhibiting decreased contrast uptake on delayed postcontrast imaging and increased nodule stiffness had biopsy-proven @entity157 . CONCLUSION: The association between @entity99 and @entity82 scores, Model for End-Stage @entity409 scores, and y-glutamyltransferase level suggests that MRE may be useful in detecting (and possibly quantifying) @entity1575 in @entity1 after the Fontan operation. The correlation between stiffness and post-Fontan time interval, mean Fontan pressure, pulmonary vascular resistance index, and reduced cardiac index suggests a role for long-term hepatic congestion in creating these @entity409 . Magnetic resonance elastography was useful in detecting abnormal nodules ultimately diagnosed as @entity157 . The relationship between stiffness with advanced @entity82 and @entity157 provides a strong argument for additional study and broader application of MRE in these @entity1 .
