Tao Katsuo, Ishikawa Yuichi, Suzuki Sayo, Muraji Shota, Kuraoka Ayako, Sato Masaki, Yamamura Kenichiro, Sagawa Koichi
Department of Cardiology, Fukuoka Children's Hospital, 5-1-1, Kashiiteriha, Higashi-Ku, Fukuoka City, Fukuoka, 813-0017, Japan.
Department of Cardiology and Intensive Care, Fukuoka Children's Hospital, Fukuoka, Japan.
Int J Cardiovasc Imaging. 2025 Feb;41(2):315-324. doi: 10.1007/s10554-024-03310-9. Epub 2024 Dec 26.
Fontan-associated liver disease (FALD) may be caused by chronic liver congestion due to high central venous pressure (CVP). Recently, the usefulness of liver native T1 mapping in magnetic resonance imaging (MRI) in adulthood has been reported. To evaluate the usefulness of native liver T1 mapping in children with congenital heart disease (CHD), we investigated the utility of native liver T1 relaxation time (LT1) in pediatric Fontan patients in comparison to other CHDs. Correlations between LT1 and laboratory biomarkers or hemodynamic data were also assessed. A total of 155 patients with CHD (biventricular repair, n = 42; bidirectional Glenn circulation, n = 38; and Fontan circulation, n = 75) underwent blood tests, cardiac catheterization, and cardiac MRI within 48 h. Both CVP and LT1 levels were higher in Fontan patients than in bidirectional Glenn and biventricular patients. There were significant correlation in the overall population and weak correlation in Fontan patients between CVP and LT1(correlation coefficient 0.644 [0.541-0.728] and 0.244 [0.0179-0.446], P < 0.001 and 0.035, respectively). Among the laboratory data, the multiple linear regression analysis revealed that the fibrosis-4 index and alanine aminotransferase were significantly correlated with LT1 in the overall population (P = 0.008,0.012), and the fibrosis-4 index was correlated with LT1 in Fontan patients (P = 0.019). LT1 might have some role to predict elevated CVP and liver injury in children with CHD.
Fontan相关肝病（FALD）可能由中心静脉压（CVP）升高导致的慢性肝淤血引起。最近，有报道称肝脏磁共振成像（MRI）中的T1值成像在成人中具有一定作用。为了评估肝脏T1值成像在先天性心脏病（CHD）儿童中的作用，我们研究了小儿Fontan患者肝脏T1弛豫时间（LT1）相对于其他CHD患者的情况。同时还评估了LT1与实验室生物标志物或血流动力学数据之间的相关性。共有155例CHD患者（双心室修复术患者42例；双向Glenn循环患者38例；Fontan循环患者75例）在48小时内接受了血液检查、心导管检查和心脏MRI检查。Fontan患者的CVP和LT1水平均高于双向Glenn循环和双心室修复术患者。在总体人群中，CVP与LT1之间存在显著相关性，而在Fontan患者中相关性较弱（相关系数分别为0.644 [0.541 - 0.728]和0.244 [0.0179 - 0.446]，P分别<0.001和0.035）。在实验室数据中，多元线性回归分析显示，纤维化-4指数和丙氨酸转氨酶在总体人群中与LT1显著相关（P = 0.008，0.012），而在Fontan患者中，纤维化-4指数与LT1相关（P = 0.019）。LT1可能在预测CHD儿童CVP升高和肝损伤方面具有一定作用。
