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Perucca G, de Lange C, Franchi-Abella S, Napolitano M, Riccabona M, Ključevšek D, Toso S, Herrmann J, Stafrace S, Darge K, Damasio MB, Bruno C, Woźniak MM, Lobo L, Ibe D, Smets AM, Petit P, Ording Müller LS. Surveillance of Fontan-associated liver disease: current standards and a proposal from the European Society of Paediatric Radiology Abdominal Task Force. Pediatr Radiol 2021; 51:2598-2606. [PMID: 34654967 PMCID: PMC8599216 DOI: 10.1007/s00247-021-05173-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/08/2021] [Accepted: 07/31/2021] [Indexed: 12/16/2022]
Abstract
Since Francis Fontan first introduced the eponymous technique, the Fontan procedure, this type of surgical palliation has allowed thousands of children affected by specific heart malformations to reach adulthood. Nevertheless, abdominal, thoracic, lymphatic and neurologic complications are the price that is paid by these patients. Our review focuses on Fontan-associated liver disease; the purpose is to summarize the current understanding of its physiopathology, the aim of follow-up and the specific radiologic follow-up performed in Europe. Finally, we as members of the Abdominal Task Force of the European Society of Paediatric Radiology propose a consensus-based imaging follow-up algorithm.
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Affiliation(s)
- Giulia Perucca
- Department of Pediatric Radiology, Regina Margherita Children’s Hospital, Turin, Italy
| | - Charlotte de Lange
- Department of Radiology and Clinical Physiology, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Stéphanie Franchi-Abella
- Pediatric Radiology Department, Hôpital Bicêtre, Hôpitaux Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Marcello Napolitano
- Department of Paediatric Radiology and Neuroradiology, V. Buzzi Children’s Hospital, Milan, Italy
| | - Michael Riccabona
- Department of Radiology, Division of Pediatric Radiology, Medical University Graz and University Hospital LKH, Graz, Austria
| | - Damjana Ključevšek
- Department of Radiology, University Children’s Hospital Ljubljana, Ljubljana, Slovenia
| | - Seema Toso
- Department of Pediatric Radiology, University Hospital of Geneva, Geneva, Switzerland
| | - Jochen Herrmann
- Department of Pediatric Radiology, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Samuel Stafrace
- Department of Diagnostic Imaging, Sidra Medicine, Doha, Qatar ,Weill Cornell Medicine, Doha, Qatar
| | - Kassa Darge
- Department of Radiology, The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA USA
| | | | - Costanza Bruno
- Department of Radiology, Azienda Ospedaliera Universitaria Integrata Verona (AOUI), Verona, Italy
| | | | - Luisa Lobo
- Serviço de Imagiologia Geral, Hospital de Santa Maria–Centro Hospitalar Universitário Lisboa, Norte (CHULN), Lisbon, Portugal
| | - Donald Ibe
- Department of Radiology, Silhouette Diagnostic Consultants, Abuja, Nigeria
| | - Anne M. Smets
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Philippe Petit
- Aix Marseille Université, AP-HM, Equipe d’Accueil 3279 - IFR 125, Hôpital Timone Enfants, Service d’Imagerie Pédiatrique et Prénatale, Marseille, France
| | - Lil-Sofie Ording Müller
- Unit for Paediatric Radiology, Department of Radiology, Oslo University Hospital, Rikshospitalet, PB 4950 Nydalen, 0424 Oslo, Norway.
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Zhao F, Zhou N, Wang JL, Zhou H, Zou LQ, Zhong WX, He J, Zheng CJ, Yan SX, Wáng YXJ. Collagen deposition in the liver is strongly and positively associated with T1rho elongation while fat deposition is associated with T1rho shortening: an experimental study of methionine and choline-deficient (MCD) diet rat model. Quant Imaging Med Surg 2020; 10:2307-2321. [PMID: 33269229 PMCID: PMC7596395 DOI: 10.21037/qims-20-651] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/22/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND A number of questions concerning the histological mechanism of elongated T1rho in liver fibrosis remain unanswered. Using a rat model of non-alcoholic fatty liver disease (NAFLD) induced with methionine and choline-deficient (MCD) diet, the primary aim of this study is to clarify whether collagen deposition per se causes liver T1rho elongation. METHODS There were 45 rats in the NAFLD model group and 8 rats in the control group. NAFLD model rats were fed MCD diet for 1, 2, 4, 6, 8, or 10 weeks, respectively. At the endpoint, the rats had in vivo MRI at 3.0 T and followed by histology. For T1rho data acquisition, a rotary echo spin-lock pulse was implemented in a three-dimensional fast field echo sequence with frequency selective fat suppression. The spin-lock frequency was set to 500 Hz, and the spin-lock times of 5, 10, 40, and 50 ms were used. Liver specimens were processed with hematoxylin-eosin staining for steatosis and inflammation evaluation, and Masson's trichrome staining for collagen visualization. The semiquantitative histopathological evaluation was based on NASH Clinical Research Network criteria. Histomorphometric analysis calculated percentages of fat and collagen accumulations in the livers. RESULTS A strong (r=0.82) and significant (P<0.0001) positive correlation between liver collagen content and liver T1rho was observed. Rats with no or minimal inflammation could have very long T1rho value. Among experimental rats without a positive fibrosis grading, five rats did not have an inflammation score (i.e., had minimal inflammation or no inflammation) while four had a positive inflammation score; the difference in liver T1rho between these two types of rats was minimal. Eight control rat livers and 15 stage-1 fibrosis rat livers were separated by liver T1rho completely. When four subgroups of experiment rats were selected where the liver collagen had a very narrow range within these subgroups, all these four subgroups showed a trend of negative correlation between liver fat and liver T1rho. CONCLUSIONS Collagen deposition in the live strongly contributes to liver T1rho elongation, while fat deposition contributes to T1rho shortening. In a well-controlled experimental setting, T1rho measure alone allows separation of healthy livers and stage-1 liver fibrosis in the MCD rat liver model.
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Affiliation(s)
- Feng Zhao
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Nan Zhou
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Ji-Li Wang
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hua Zhou
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li-Qiu Zou
- Department of Radiology, The Sixth Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Wei-Xiang Zhong
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jian He
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Cun-Jing Zheng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Sen-Xiang Yan
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yì Xiáng J. Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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Song J, Yu X, Song W, Guo D, Li C, Liu H, Zhang H, Zhou J, Liu Y. MRI
‐Based Radiomics Models Developed With Features of the Whole Liver and Right Liver Lobe: Assessment of Hepatic Inflammatory Activity in Chronic Hepatic Disease. J Magn Reson Imaging 2020; 52:1668-1678. [PMID: 32445618 DOI: 10.1002/jmri.27197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 12/15/2022] Open
Affiliation(s)
- Junjie Song
- Department of Radiology Second Affiliated Hospital of Chongqing Medical University Chongqing China
| | - Xiangling Yu
- Department of Radiology Second Affiliated Hospital of Chongqing Medical University Chongqing China
| | - Wenlong Song
- Department of Radiology Second Affiliated Hospital of Chongqing Medical University Chongqing China
| | - Dajing Guo
- Department of Radiology Second Affiliated Hospital of Chongqing Medical University Chongqing China
| | - Chuanming Li
- Department of Radiology Second Affiliated Hospital of Chongqing Medical University Chongqing China
| | | | - Haiping Zhang
- Department of Radiology Second Affiliated Hospital of Chongqing Medical University Chongqing China
| | - Jun Zhou
- Department of Radiology Second Affiliated Hospital of Chongqing Medical University Chongqing China
| | - Yangyang Liu
- Department of Radiology Second Affiliated Hospital of Chongqing Medical University Chongqing China
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