ArticleJACC. Advances2024
Liver Imaging in Fontan Patients: How Does Ultrasound Compare to Cross-Sectional Imaging?
Article in JACC. Advances, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Fontan-associated liver disease in children following surgical correction of congenital heart defects.Clinical and experimental hepatology · 2026Review
- Long-Term Care in Fontan Circulation: Surveillance and Management of Fontan-Associated Liver Disease and Protein-Losing Enteropathy.Current cardiology reports · 2026Review
- Ultrasound Evaluation of Fontan-Associated Liver Disease: A State-of-the-Art Review.Diagnostics (Basel, Switzerland) · 2025Review
- Fontan-Associated Liver Disease.Seminars in liver disease · 2025Review
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Fontan patients frequently develop liver cirrhosis (LC); however, the diagnostic accuracy of ultrasound (US) for detecting LC and the clinical implications of such diagnoses have not been clearly established. Objectives: This study aims to evaluate the diagnostic performance of US for detecting LC in an adult population with Fontan circulation and to determine the correlation between LC and mortality/transplantation. Methods: This was a retrospective study. Data on cross-sectional imaging, liver USs, and clinical visits that occurred within 12 months of the cross-sectional imaging were collected. Liver US diagnostic accuracy was evaluated against cross-sectional imaging. Kappa agreement between methods was assessed. Univariate Cox proportional hazards regression analysis was employed to compare mortality and transplant outcomes. Results: Overall, 131 patients were included. Liver US and cross-sectional imaging (computed tomography 74, magnetic resonance imaging 57) was performed in all patients. Liver US reported heterogeneous parenchyma, lobar redistribution, and surface nodularity in 85.4%, 72.5%, and 65.6% of cases. Cross-sectional imaging reported these features in 60.3%, 87.0%, and 84.9% of cases, respectively. US sensitivity was greater than 0.75 for all variables, while specificity was 0.21, 0.58, and 0.85, respectively. LC was diagnosed in 78% of cases by US and in 90% by cross-sectional imaging, with a kappa agreement of 0.21 between techniques. There was no significant correlation between the presence of hepatic parenchymal changes or cirrhosis and mortality/transplantation. Conclusions: Liver US is effective for screening and monitoring liver cirrhotic features in the adult Fontan population. In a univariate analysis, there was no association between LC and mortality or transplantation.
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