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Liver nodules after the Fontan operation: role of the computerised tomography scan

Part of: Advanced Imaging

Published online by Cambridge University Press:  09 August 2021

Saviga Sethasathien ,
Suchaya Silvilairat Open the ORCID record for Suchaya Silvilairat [Opens in a new window] ,
Rekwan Sittiwangkul ,
Krit Makonkawkeyoon ,
Yupada Pongprot  and
Surin Woragidpoonpol
Saviga Sethasathien
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Suchaya Silvilairat*
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Rekwan Sittiwangkul
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Krit Makonkawkeyoon
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Yupada Pongprot
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Surin Woragidpoonpol
Affiliation:
Division of Cardiovascular and thoracic surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
*
Author for correspondence: Suchaya Silvilairat, MD, Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200Thailand. Tel: 6689-761-2855; Fax: 6653-93-6461. E-mail: asilvilairat@gmail.com
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Abstract

Currently, there is an increasing prevalence of liver nodules in patients following the Fontan operation. The appropriate non-invasive modalities have been applied to assess a diagnosis of Fontan-associated liver disease. The aims of this study were to determine the prevalence and associated factors for the presence of liver nodules using CT scan. A cross-sectional study of 34 patients older than 15 years of age was recruited. Ultrasound upper abdomen, ultrasound liver elastography, and CT scan of the upper abdomen were performed after the Fontan operation. The median age of patients was 20 years (range 14–36 years). The median age at the Fontan operation was 7 years (range 5–17 years) and the duration after the Fontan operation was 12 years (range 4–22 years). The prevalence of liver nodules was 62% as detected by CT scans. Hepatic vein pressure in patients with liver nodules was significantly higher than in those without liver nodules. Hepatic vein pressure above 13 mmHg was a factor associated with liver nodules. There was little agreement between the ultrasound of the upper abdomen and CT scan of the upper abdomen in the evaluation of liver nodules. Hepatic pressure was the only associated factor for the occurrence of liver nodules in patients following the Fontan operation. The prevalence of liver nodules was very high after the Fontan operation. The upper abdomen CT scan should be performed for the surveillance of liver nodules in every Fontan patient over the age of 15 years.

Keywords

Computerised tomography scanultrasound of the upper abdomen and ultrasound liver elastographyFontan operationFontan-associated liver diseaseliver noduleshepatic pressure
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 6 , June 2022 , pp. 930 - 935
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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