Noninvasive Liver Assessment in Adult Patients With Fontan Circulation Using Acoustic Radiation Force Impulse Elastography and Hepatic Magnetic Resonance Imaging

In a prospective cross-sectional analysis of 37 adult patients palliated with a Fontan procedure, Buendía-Fuentes and colleagues assessed liver disease by three techniques: hepatic magnetic resonance imaging (MRI), acoustic radiation force impulse (ARFI) imaging, and hepatic ultrasound. They authors compared the prevalence of disease and the diagnostic conclusion between different techniques. They also evaluated the association between the diagnosis from noninvasive imaging and clinical variables such as liver disease biomarkers. Signs of liver disease were observed in most patients by both hepatic MRI and ARFI elastography, but not by ultrasound imaging. Increased liver stiffness did not identify specific disease patterns from MRI, supporting the need for multimodality imaging to characterize liver disease in Fontan patients.