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Using T1 map** in cardiovascular magnetic resonance to assess congestive hepatopathy

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Abstract

The goal of this study was to assess the ability of quantitative T1 cardiovascular magnetic resonance (CMR) imaging to calculate liver extracellular volume (ECV) in patients with varying degrees of congestive hepatopathy (CH). T1 measurements and ECV calculations were performed retrospectively in three cohorts of patients: normal cardiac function, tetralogy of fallot (TOF) repair and Fontan palliation. All CMR studies included modified look-locker inversion recovery (MOLLI) T1 map** scans performed pre- and post-injection of a gadolinium-based contrast agent (GBCA). Pixel intensity data were manually collected from images of the liver and cardiac blood pool to determine contrast-induced changes in T1 for liver and blood. These data were then used to compute liver ECV. 172 subjects were included in the study. Of these, 140 subjects were normal cardiac function patients, 16 were TOF repair patients and 16 patients were with Fontan palliation. A statistically significant difference in both the liver native T1 and ECV measurements was found between patients with normal cardiac function vs. Fontan palliation patients (p < 0.01). Our data indicate that measuring T1 maps both pre- and post-GBCA injection within CMR scan session can be used to follow progression of liver fibrosis. This technique has the potential to improve diagnosis and treatment of patients with chronic liver disease and liver fibrosis.

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Abbreviations

CMR:

Cardiovascular magnetic resonance

ECV:

Extracellular volume

CH:

Congestive hepatopathy

TOF:

Tetralogy of Fallot

MOLLI:

Modified look-locker inversion recovery

GBCA:

Gadolinium-based contrast agent

MR:

Magnetic resonance

HCT:

Haematocrit

SD:

Standard deviation

ROC:

Receiver operator characteristic

DMD:

Duchenne muscular dystrophy

PHVC:

Passive hepatic venous congestion

AUC:

Area under curve

PACS:

Picture archiving computer system

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Acknowledgements

We would like to thank the Summer Undergraduate Research Fellowship (SURF) program at Cincinnati Children’s Hospital Medical Center.

Availability of data and material

The PACS system (Merge; Chicago, IL, USA) was searched for all patients who had a dedicated CMR examination.

Author information

Author notes

  1. Isabel Kazour and Suraj D. Serai have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, MLC 5031, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Isabel Kazour, Suraj D. Serai & Robert J. Fleck

  2. Department of Radiology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Suraj D. Serai

  3. Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Stavra A. Xanthakos

  4. Nutritional Biochemistry and Metabolism, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA

    Isabel Kazour

Authors
  1. Isabel Kazour
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  2. Suraj D. Serai
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  3. Stavra A. Xanthakos
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  4. Robert J. Fleck
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Contributions

All authors read, critically edited the initial manuscript, added intellectual content and approved the final version. IMK, SDS and RJF designed, coordinated and conducted the study. IMK acquired all data and was mentored by SDS under the SURF program. SX assisted with study design and added critical manuscript content.

Corresponding author

Correspondence to Suraj D. Serai.

Ethics declarations

Funding

This research was partially supported by a grant from the NIH, R01DK100429.

Conflict of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board and all study procedures were performed in a HIPPA compliant manner.

Informed consent

This was a retrospective study and informed consent was waived by the IRB.

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Kazour, I., Serai, S.D., Xanthakos, S.A. et al. Using T1 map** in cardiovascular magnetic resonance to assess congestive hepatopathy. Abdom Radiol 43, 2679–2685 (2018). https://doi.org/10.1007/s00261-018-1528-x

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