Noninvasive ultrasound technique for assessment of liver fibrosis and cardiac function in Fontan-associated liver disease: diagnosis based on elastography and hepatic vein waveform type
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- KOIZUMI Yohei
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
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- HIROOKA Masashi
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
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- TANAKA Takaaki
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
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- WATANABE Takao
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
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- YOSHIDA Osamu
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
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- TOKUMOTO Yoshio
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
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- HIGAKI Takashi
- Molecule and Function, Department of Pediatrics, Ehime University Graduate School of Medicine
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- EGUCHI Mariko
- Department of Pediatrics, Ehime University Graduate School of Medicine
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- ABE Masanori
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
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- HIASA Yoichi
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
Bibliographic Information
- Other Title
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- フォンタン術後症例における非侵襲的肝線維化診断と循環動態評価:肝静脈波形とエラストグラフィの有用性の検討
Abstract
<p>Purpose: Patients with a Fontan circulation tend to develop liver fibrosis, liver cirrhosis and even hepatocellular carcinoma. A noninvasive ultrasound technique for liver fibrosis and cardiac function assessment in Fontan-associated liver disease (FALD) is needed to evaluate disease progression in real time. This study aimed to evaluate whether hepatic vein (HV) waveform analysis and elastography could be alternative markers to cardiac index (CI) in patients with FALD and assess factors influencing elastography measurements in FALD cases. Methods: All patients underwent cardiac catheterization, B-mode ultrasound and ultrasound elastography measurement. Moreover, we measured serum markers related to fibrosis and examined HV blood flow using duplex Doppler ultrasonography. Results: Forty-three patients (median age, 17 years; interquartile range, 12-25 years; 29 men, 6 with liver biopsy) were enrolled. The real-time tissue elastography (RTE) value was significantly higher in patients who underwent surgery > 7 years prior, suggesting that this value probably reflects the liver fibrosis due to FALD from the early fibrosis stage. The ultrasound elastography did not significantly correlate with hemodynamic parameters. The area under the receiver operating curve for the diagnosis of CI < 2.2 L/min/m2 using HV waveform was superior to the results from elastography and calculated fibrosis indices. Conclusion: HV waveform can be used as a noninvasive measurable surrogate marker for CI. The RTE value increased overtime after the operation and would reflect liver fibrosis. The combination of RTE and HV waveform type could be useful noninvasive tools to evaluate clinical conditions in FALD patients in real time.</p>
Journal
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- Choonpa Igaku
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Choonpa Igaku 50 (5), 365-374, 2023
The Japan Society of Ultrasonics in Medicine
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Keywords
Details 詳細情報について
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- CRID
- 1390297437856744960
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- ISSN
- 18819311
- 13461176
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
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- Abstract License Flag
- Disallowed