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

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.

Application of Intravoxel Incoherent Motion in Clinical Liver Imaging: A Literature Review

“…A study by Shiraga et al revealed that IVIM technique could differentiate pre-fibrotic liver states in young Fontan patients without any influence from central venous pressure. 58 Decreased PF was also shown to have the potential to predict hepatic venous pressure gradient in liver cirrhosis. 59 Li et al identified a potential correlation between lower PF, D fast , and serum liver function biomarkers, 50 contributing to the evaluation of liver function.…”

“…IVIM also has a wide range of applications in fibrosis‐related diseases. A study by Shiraga et al revealed that IVIM technique could differentiate pre‐fibrotic liver states in young Fontan patients without any influence from central venous pressure 58 . Decreased PF was also shown to have the potential to predict hepatic venous pressure gradient in liver cirrhosis 59 .…”

Progress of intravoxel incoherent motion diffusion-weighted imaging in liver diseases

“…Studies[ 12 , 44 , 45 ] have shown that the D, D* and f values of hepatic fibrosis patients were significantly lower than those in normal control groups. The IVIM-DWI parameters D, D* and f can be used to distinguish healthy people from patients with hepatic fibrosis, with the f value exhibiting the best diagnostic value[ 38 ].The study by Shiraga et al[ 36 ] showed that IVIM-DWI also identified a pre-fibrotic state of the liver in Fontan patients. The study included five consecutive Fontan patients and four age-matched healthy volunteers.…”