Evidence map›Paper›PMID 40879718›Full record

ArticlePediatric radiology2025

Liver stiffness measured by MR elastography in children and adults with Fontan circulation: defining expected values and clinical associations.

Julia Razavi, Andrew T Trout, Cara E Morin, Alexander R Opotowsky, Clayton Smith, Joseph J Palermo, Julie A Bonn, Jonathan R Dillman

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Article in Pediatric radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Julia RazaviDepartment of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
Andrew T TroutDepartment of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
Cara E MorinDepartment of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
Alexander R OpotowskyDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Clayton SmithDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Joseph J PalermoDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Julie A BonnDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Jonathan R DillmanDepartment of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA. jonathan.dillman@cchmc.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMRI is increasingly used to assess Fontan-associated liver disease (FALD), but the expected range and variability of MR elastography (MRE) shear stiffness measurements as well as their clinical associations remain poorly understood.

objectiveThis study aimed to define the range of MR elastography (MRE) measured liver shear stiffness and its clinical associations in a large pediatric and adult cohort of patients post-Fontan. MATERIALS AND

methodsThis retrospective cross-sectional study included children and adults who underwent baseline clinical liver MRE between February 2013 and June 2024. Mean liver stiffness (kPa) and liver volume (mL) were obtained from clinical reports, while spleen length was measured on coronal T2-weighted images. Clinical data, Fontan conduit size, Fontan pathway pressure, fenestration status, and presence of protein-losing enteropathy were collected within 6 months of imaging. Associations between liver stiffness and clinical variables were assessed using Pearson correlation and multiple linear regression. Clinical characteristics were compared between patients in the lowest (≤ 20th) and highest (≥ 80th) percentiles of liver stiffness.

resultsOur study sample included 206 Fontan patients (mean age 19.7 years; 114 male). Mean liver stiffness was 4.4 ± 1.0 kPa (range 2.1-7.4 kPa). Liver stiffness was associated with aspartate aminotransferase (AST) (r=0.23, P=0.003), total bilirubin (r=0.31, P<0.0001), and male sex (4.6 vs. 4.1 kPa; P=0.0002), but not with liver volume (r=0.06, P=0.39) or spleen length (r=0.08, P=0.25). In a regression model excluding Fontan conduit size and Fontan pressure (n=143), male sex (P = 0.02), total bilirubin (P=0.003), and AST (P = 0.048) were independent predictors of liver stiffness (R

conclusionMRE liver stiffness is elevated and highly variable in individuals with Fontan circulation, with higher measurements associated with male sex, liver-related laboratory changes, and Fontan pathway pressure.

Indexed as

Elasticity Imaging TechniquesFontan ProcedureLiverLiver DiseasesMagnetic Resonance ImagingPostoperative ComplicationsAdolescentAdultChildChild, PreschoolCross-Sectional StudiesFemaleHumansMaleRetrospective StudiesYoung AdultAdultsChildrenFontanLiver stiffnessMR elastography

Identifiers

PMID40879718
PMCPMC12602590

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