https://observatorio.fm.usp.br/handle/OPI/29890
Title: | Multimodality Screening of Hepatic Nodules in Patients With Congenital Heart Disease After Fontan Procedure: Role of Ultrasound, ARFI Elastography, CT, and MRI |
Authors: | HORVAT, Natally; ROCHA, Manoel Souza; CHAGAS, Aline Lopes; OLIVEIRA, Brunna Clemente; PACHECO, Mariana Poltronieri; BINOTTO, Maria Angelica; IKARI, Nana Miura; PARANAGUA-VEZOZZO, Denise Cerqueira; LEAO-FILHO, Hilton Muniz; VICENTINI, Joao Rafael Terneira; SILVA FILHO, Mauricio Ricardo Moreira da; JATENE, Marcelo Biscegli; CARRILHO, Flair Jose; CERRI, Giovanni Guido |
Citation: | AMERICAN JOURNAL OF ROENTGENOLOGY, v.211, n.6, p.1212-1220, 2018 |
Abstract: | OBJECTIVE. Currently, there is no consensus in the literature regarding the screening of hepatic nodules in patients who have undergone the Fontan procedure. The objectives of this study are to evaluate in this population the frequency of hepatic nodules at ultrasound (US), CT, and MRI; to measure liver stiffness using acoustic radiation force impulse (ARFI) elastography; and to investigate predictive factors for hepatic nodules. SUBJECTS AND METHODS. In this cross-sectional study, 49 patients who underwent the Fontan procedure were prospectively recruited from August 2014 through June 2016. These patients underwent clinical evaluation for hepatic disorders, ARFI elastography, US, CT, and MRI. RESULTS. Most of the patients had no symptoms, and hepatic nodules were detected in three of 49 (6.1%) patients at US, 14 of 44 (31.8%) patients at CT, and 19 of 48 (39.6%) patients at MRI. Liver stiffness at ARFI elastography was significantly higher in patients with hepatic nodules than i n patients without such nodules (2.64 +/- 0.81 m/s vs 1.94 +/- 0.49 m/s; p = 0.002) and was a significant predictor of hepatic nodule (AUC, 0.767; p = 0.002). No clinical or laboratory data had any significant correlation with the existence of hepatic nodules, including time since Fontan procedure. CONCLUSION. In our study, more than one-third of patients had hepatic nodules at CT or MRI, but US did not detect most hepatic nodules. Liver stiffness at ARFI elastography was significantly higher in patients with hepatic nodules, and it may help guiding which patient should be further imaged with CT or MRI. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCP Artigos e Materiais de Revistas Científicas - FM/MDR Artigos e Materiais de Revistas Científicas - FM/MGT Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - HC/InCor Artigos e Materiais de Revistas Científicas - HC/InRad Artigos e Materiais de Revistas Científicas - LIM/07 Artigos e Materiais de Revistas Científicas - LIM/11 Artigos e Materiais de Revistas Científicas - LIM/44 Artigos e Materiais de Revistas Científicas - ODS/03 |
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