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Spectrum of Fontan-...
Spectrum of Fontan-associated liver disease assessed by MRI and US in young adolescents
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Thrane, Karl Julius (författare)
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Müller, Lil Sofie Ording (författare)
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Suther, Kathrine Rydén (författare)
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Thomassen, Kristian Stien (författare)
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Holmström, Henrik (författare)
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Thaulow, Erik (författare)
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Almaas, Runar (författare)
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Möller, Thomas (författare)
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- de Lange, Charlotte, 1963 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology
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(creator_code:org_t)
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- 2021-03-10
- 2021
- Engelska.
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Ingår i: Abdominal Radiology. - : Springer Science and Business Media LLC. - 2366-004X .- 2366-0058. ; 46:7, s. 3205-3216
- Relaterad länk:
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https://link.springe...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Purpose: Patients with Fontan circulation are at risk of developing hepatic fibrosis/cirrhosis. The mechanisms and disease development are unclear and early secondary liver cancer is a concern. This study will describe hepatic imaging findings in a national cohort of adolescents with Fontan circulation. Methods: The patients prospectively underwent abdominal contrast enhanced magnetic resonance imaging (MRI) including diffusion-weighted imaging. Images were assessed for criteria of fibrosis/cirrhosis including characterization of hepatic nodules. These nodules were in addition, assessed by ultrasonography (US). Nodules ≥ 1 cm were investigated and monitored to evaluate malignant transformation. Clinical and hepatic serological data were recorded. Results: Forty-six patients, median age of 16.5 years (15.4–17.9 years) were enrolled. All patients underwent US examination and MRI was performed in 35/46 patients. On MRI, 60% had hepatomegaly and 37% had signs of fibrosis/cirrhosis. Seven patients had together 13 nodules ≥ 1 cm in diameter. Only 4/13 (17%) where seen on US. Nodules had variable MRI signal characteristics including hepatobiliary contrast enhancement and two nodules revealed portal venous phase ‘wash-out’ on the first examination. No further imaging signs of malignancy were revealed during the follow-up period of median 24.4 (7–42) months. Conclusion: The majority of adolescents with Fontan circulation had imaging findings of fibrosis/cirrhosis of varying severity. US had low detection rate of hepatic nodules compared to MRI. The imaging work-up before transition to adult cardiology care did not reveal findings suggestive of malignancy. However, the high prevalence of Fontan-associated liver disease calls for surveillance strategies even in childhood.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Nyckelord
- Diffusion-weighted imaging
- Fontan procedure
- Liver cirrhosis
- Magnetic resonance imaging
- Univentricular heart
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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