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Intravoxel incoherent motion imaging has the possibility to detect liver abnormalities in young Fontan patients with good hemodynamics

Published online by Cambridge University Press:  28 June 2019

Kazuhiro Shiraga
Affiliation:
Department of Cardiology, Chiba Children’s Hospital, Chiba, Japan Department of Pediatrics, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
Kojiro Ono
Affiliation:
Department of Radiology, Chiba Children’s Hospital, Chiba, Japan Division of Fundamental Engineering, Graduate School of Science and Engineering, Chiba University, Chiba, Japan
Ryo Inuzuka
Affiliation:
Department of Pediatrics, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
Hiroko Asakai
Affiliation:
Department of Pediatrics, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
Takumi Ookubo
Affiliation:
Department of Radiology, Chiba Children’s Hospital, Chiba, Japan
Akira Shirayama
Affiliation:
Department of Radiology, Chiba Children’s Hospital, Chiba, Japan
Kouji Higashi
Affiliation:
Department of Cardiology, Chiba Children’s Hospital, Chiba, Japan
Hiromichi Nakajima*
Affiliation:
Department of Cardiology, Chiba Children’s Hospital, Chiba, Japan
*
Author for correspondence: Hiromichi Nakajima, Department of Cardiology, Chiba Children’s Hospital, 579-1 Hetachou, Midori-ku, Chiba city, Chiba 2660007 Japan. Tel: +81-43-292-2111; Fax: +81-43-292-3815; E-mail: [email protected]

Abstract

Introduction:

Liver fibrosis and cirrhosis are one of the critical complications in Fontan patients. However, there are no well-established non-invasive and quantitative techniques for evaluating liver abnormalities in Fontan patients. Intravoxel incoherent motion diffusion-weighted imaging with MRI is a non-invasive and quantitative method to evaluate capillary network perfusion and molecular diffusion. The objective of this study is to assess the feasibility of intravoxel incoherent motion imaging in evaluating liver abnormalities in Fontan children.

Materials and Methods:

Five consecutive Fontan patients and four age-matched healthy volunteers were included. Fontan patients were 12.8 ± 1.5 years old at the time of MRI scan. Intravoxel incoherent motion imaging parameters (D, D*, and f values) within the right hepatic lobe were compared. Laboratory test, ultrasonography, and cardiac MRI were also conducted in the Fontan patients. Results of cardiac catheterization conducted within one year of the intravoxel incoherent motion imaging were also examined.

Results:

In Fontan patients, laboratory test and liver ultrasonography showed almost normal liver condition. Cardiac catheter and MRI showed good Fontan circulation. Cardiac index was 2.61 ± 0.23 L/min/m2. Intravoxel incoherent motion imaging parameters D, D*, and f values were lower in Fontan patients compared with controls (D: 1.1 ± 0.0 versus 1.3 ± 0.2 × 10−3 mm2/second (p = 0.04), D*: 30.8 ± 24.8 versus 113.2 ± 25.6 × 10−3 mm2/second (p < 0.01), and f: 13.2 ± 3.1 versus 22.4 ± 2.4% (p < 0.01), respectively).

Conclusions:

Intravoxel incoherent motion imaging is feasible for evaluating liver abnormalities in children with Fontan circulation.

Type
Original Article
Copyright
© Cambridge University Press 2019 

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References

Chon, YE, Kim, SU, Park, JY, et al. Dynamics of the liver stiffness value using transient elastography during the perioperative period in patients with valvular heart disease. PLoS One 2014; 9: e92795.CrossRefGoogle ScholarPubMed
Colli, A, Pozzoni, P, Berzuini, A, et al. Decompensated chronic heart failure: increased liver stiffness measured by means of transient elastography. Radiology 2010; 257: 872878.10.1148/radiol.10100013CrossRefGoogle ScholarPubMed
Jalal, Z, Iriart, X, De Ledinghen, V, et al. Liver stiffness measurements for evaluation of central venous pressure in congenital heart diseases. Heart 2015; 101: 14991504.CrossRefGoogle ScholarPubMed
Millonig, G, Friedrich, S, Adolf, S, et al. Liver stiffness is directly influenced by central venous pressure. J Hepatol 2010; 52: 206210.CrossRefGoogle ScholarPubMed
Le Bihan, D. Intravoxel incoherent motion imaging using steady-state free precession. Magn Reson Med 1988; 7: 346351.CrossRefGoogle ScholarPubMed
Le Bihan, D, Breton, E, Lallemand, D, et al. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 1988; 168: 497505.CrossRefGoogle ScholarPubMed
Le Bihan, D, Turner, R, MacFall, JR. Effects of intravoxel incoherent motions (IVIM) in steady-state free precession (SSFP) imaging: application to molecular diffusion imaging. Magn Reson Med 1989; 10: 324337.10.1002/mrm.1910100305CrossRefGoogle ScholarPubMed
Le Bihan, D, Turner, R. Intravoxel incoherent motion imaging using spin echoes. Magn Reson Med 1991; 19: 221227.10.1002/mrm.1910190206CrossRefGoogle ScholarPubMed
Annet, L, Peeters, F, Abarca-Quinones, J, et al. Assessment of diffusion-weighted MR imaging in liver fibrosis. J Magn Reson Imaging 2007; 25: 122128.10.1002/jmri.20771CrossRefGoogle ScholarPubMed
Luciani, A, Vignaud, A, Cavet, M, et al. Liver cirrhosis: intravoxel incoherent motion MR imaging--pilot study. Radiology 2008; 249: 891899.10.1148/radiol.2493080080CrossRefGoogle ScholarPubMed
Taouli, B, Chouli, M, Martin, AJ, et al. Chronic hepatitis: role of diffusion-weighted imaging and diffusion tensor imaging for the diagnosis of liver fibrosis and inflammation. J Magn Reson Imaging 2008; 28: 8995.CrossRefGoogle Scholar
Sandrasegaran, K, Akisik, FM, Lin, C, et al. Value of diffusion-weighted MRI for assessing liver fibrosis and cirrhosis. AJR Am J Roentgenol 2009; 193: 15561560.10.2214/AJR.09.2436CrossRefGoogle ScholarPubMed
Watanabe, H, Kanematsu, M, Goshima, S, et al. Staging hepatic fibrosis: comparison of gadoxetate disodium-enhanced and diffusion-weighted MR imaging–preliminary observations. Radiology 2011; 259: 142150.10.1148/radiol.10100621CrossRefGoogle ScholarPubMed
Anderson, SW, Barry, B, Soto, JA, et al. Quantifying hepatic fibrosis using a biexponential model of diffusion weighted imaging in ex vivo liver specimens. Magn Reson Imaging 2012; 30: 14751482.10.1016/j.mri.2012.05.010CrossRefGoogle ScholarPubMed
Jiang, H, Chen, J, Gao, R, et al. Liver fibrosis staging with diffusion-weighted imaging: a systematic review and meta-analysis. Abdom Radiol (NY) 2017; 42: 490501.CrossRefGoogle ScholarPubMed
Patel, J, Sigmund, EE, Rusinek, H, et al. Diagnosis of cirrhosis with intravoxel incoherent motion diffusion MRI and dynamic contrast-enhanced MRI alone and in combination: preliminary experience. J Magn Reson Imaging 2010; 31: 589600.CrossRefGoogle ScholarPubMed
Chung, SR, Lee, SS, Kim, N, et al. Intravoxel incoherent motion MRI for liver fibrosis assessment: a pilot study. Acta Radiol 2015; 56: 14281436.CrossRefGoogle ScholarPubMed
Zhang, B, Liang, L, Dong, Y, et al. Intravoxel Incoherent Motion MR Imaging for Staging of Hepatic Fibrosis. PLoS One 2016; 11: e0147789.CrossRefGoogle ScholarPubMed
Zhang, J, Guo, Y, Tan, X, et al. MRI-based estimation of liver function by intravoxel incoherent motion diffusion-weighted imaging. Magn Reson Imaging 2016; 34: 12201225.CrossRefGoogle ScholarPubMed
Dijkstra, H, Oudkerk, M, Kappert, P, Sijens, PE. Assessment of the link between quantitative biexponential diffusion-weighted imaging and contrast-enhanced MRI in the liver. Magn Reson Imaging 2017; 38: 4753.CrossRefGoogle ScholarPubMed
Dijkstra, H, Wolff, D, van Melle, JP, et al. Diminished liver microperfusion in Fontan patients: a biexponential DWI study. PLoS One 2017; 12: e0173149.10.1371/journal.pone.0173149CrossRefGoogle ScholarPubMed
Lu, PX, Huang, H, Yuan, J, et al. Decreases in molecular diffusion, perfusion fraction and perfusion-related diffusion in fibrotic livers: a prospective clinical intravoxel incoherent motion MR imaging study. PLoS One 2014; 9: e113846.CrossRefGoogle ScholarPubMed
Kotelanski, B, Groszmann, R, Cohn, JN. Circulation times in the splanchnic and hepatic beds in alcoholic liver disease. Gastroenterology 1972; 63: 102111.CrossRefGoogle ScholarPubMed
Groszmann, RJ, Vorobioff, J, Riley, E. Splanchnic hemodynamics in portal-hypertensive rats: measurement with gamma-labeled microspheres. Am J Physiol 1982; 242: G156160.Google ScholarPubMed
Vorobioff, J, Bredfeldt, JE, Groszmann, RJ. Hyperdynamic circulation in portal-hypertensive rat model: a primary factor for maintenance of chronic portal hypertension. Am J Physiol - Gastrointest Liver Physiol 1983; 244: G52G57.10.1152/ajpgi.1983.244.1.G52CrossRefGoogle ScholarPubMed
Hayashi, T, Miyati, T, Takahashi, J, et al. Diffusion analysis with triexponential function in liver cirrhosis. J Magn Reson Imaging 2013; 38: 148153.CrossRefGoogle ScholarPubMed
Hu, G, Chan, Q, Quan, X, et al. Intravoxel incoherent motion MRI evaluation for the staging of liver fibrosis in a rat model. J Magn Reson Imaging 2015; 42: 331339.10.1002/jmri.24796CrossRefGoogle ScholarPubMed
Ichikawa, S, Motosugi, U, Morisaka, H, et al. MRI-based staging of hepatic fibrosis: Comparison of intravoxel incoherent motion diffusion-weighted imaging with magnetic resonance elastography. J Magn Reson Imaging 2015; 42: 204210.CrossRefGoogle ScholarPubMed
Wu, CH, Ho, MC, Jeng, YM, et al. Assessing hepatic fibrosis: comparing the intravoxel incoherent motion in MRI with acoustic radiation force impulse imaging in US. Eur Radiol 2015; 25: 35523559.CrossRefGoogle ScholarPubMed
Gewillig, M, Brown, SC, Eyskens, B, et al. The Fontan circulation: who controls cardiac output? Interact Cardiovasc Thorac Surg 2010; 10: 428433.CrossRefGoogle ScholarPubMed
Schwartz, MC, Sullivan, L, Cohen, MS, et al. Hepatic pathology may develop before the Fontan operation in children with functional single ventricle: an autopsy study. J Thorac Cardiovasc Surg 2012; 143: 904909.10.1016/j.jtcvs.2011.08.038CrossRefGoogle Scholar
Johnson, JA, Cetta, F, Graham, RP, et al. Identifying predictors of hepatic disease in patients after the Fontan operation: a postmortem analysis. J Thorac Cardiovasc Surg 2013; 146: 140145.CrossRefGoogle ScholarPubMed
Ginde, S, Hohenwalter, MD, Foley, WD, et al. Noninvasive assessment of liver fibrosis in adult patients following the Fontan procedure. Congenit Heart Dis 2012; 7: 235242.CrossRefGoogle ScholarPubMed
Janes, CH, Lindor, KD. Outcome of patients hospitalized for complications after outpatient liver biopsy. Ann Intern Med 1993; 118: 9698.CrossRefGoogle ScholarPubMed
Bravo, AA, Sheth, SG, Chopra, S. Liver biopsy. N Engl J Med 2001; 344: 495500.CrossRefGoogle ScholarPubMed
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