Hepatic pathology after Fontan palliation: spectrum of imaging findings.

Background: Patients with congenital heart disease corrected by Fontan palliation have chronic liver congestion that commonly progresses to fibrosis and cirrhosis with resultant complications.Objective: To define the hepatic imaging characteristics associated with Fontan circulation.Materials and Me...

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Publicado en:Pediatric Radiology Vol. 43; no. 3; pp. 330 - 339
Autores principales: Wallihan, Daniel B, Podberesky, Daniel J
Formato: research Journal Article
Publicado: Springer Nature Mar2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2013
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00247-012-2531-y
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        atl: Hepatic pathology after Fontan palliation: spectrum of imaging findings.
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        au:
          Wallihan, Daniel B
          Podberesky, Daniel J
        affil: Cincinnati Children's Hospital Medical Center, 3333 Burnett Ave., Cincinnati, OH, 45229, USA, daniel.wallihan@cchmc.org.
      sug:
        subj:
          Cardiopulmonary Bypass Adverse Effects
          Heart Defects, Congenital Surgery
          Liver Cirrhosis Diagnosis
          Liver Cirrhosis Etiology
          Magnetic Resonance Imaging Methods
          Tomography, X-Ray Computed Methods
          Adolescence
          Child
          Child, Preschool
          Female
          Heart Defects, Congenital Complications
          Heart Defects, Congenital Diagnosis
          Human
          Infant
          Male
          Middle Age
          Palliative Care Methods
          Retrospective Design
          Treatment Outcomes
          Young Adult
          Adolescent: 13-18 years
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Infant: 1-23 months
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Patients with congenital heart disease corrected by Fontan palliation have chronic liver congestion that commonly progresses to fibrosis and cirrhosis with resultant complications.Objective: To define the hepatic imaging characteristics associated with Fontan circulation.Materials and Methods: A retrospective study was performed in patients who underwent Fontan palliation who had CT or MR examinations including the liver. The liver was evaluated for parenchymal morphology, abnormal enhancement, nodules and imaging findings of fibrosis and cirrhosis.Results: MRI or CT examinations including the liver were evaluated in 42 Fontan patients. The most common imaging finding was abnormal parenchymal enhancement, present in 38 patients. Hypervascular nodules were present in 13 patients (31%). Imaging findings of cirrhosis were seen in eight patients (19%). One patient with cirrhosis had a large liver mass, subsequently diagnosed as fibrolamellar hepatocellular carcinoma.Conclusion: A high percentage of patients had imaging abnormalities of the liver, chiefly abnormal parenchymal enhancement, which became more apparent as the duration of the Fontan circulation increased. The hypervascular nodules sometimes present had imaging characteristics most closely resembling those of focal nodular hyperplasia. The underlying fibrosis and eventual development of cirrhosis raise the risk of developing hepatocellular carcinoma.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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