Wednesday, December 4 | 9:50 a.m.-10:00 a.m. | W3-SSGI12-3 | Room E352
Attendees in this session can see what researchers are calling the first study to evaluate the diagnostic accuracy of ultrasound for monitoring Fontan liver disease in an adult population.
Ciara O’Brien, MD, of the University of Toronto, will present her team’s findings demonstrating that liver ultrasound can accurately detect features of liver cirrhosis and hepatic nodules in patients with Fontan circulation.
Fontan circulation refers to low cardiac output and elevated central venous pressure, though with the absence of a subpulmonary ventricle. Fontan operations make cardiovascular pathology symptoms less severe, but they may also cause liver congestion with associated progressive liver fibrosis. Fontan procedures are typically performed in children.
O’Brien and colleagues studied the diagnostic performance of ultrasound for detecting liver cirrhosis and nodules in adult patients with Fontan circulation. Their goal was to determine a potential correlation between liver cirrhosis and mortality/transplantation.
The study included 131 patients with an average age of 34.4 years, of whom 57 (43.5%) were female. The team noted that the most common type of Fontan procedure included in the study was an extracardiac conduit, performed in 66 patients (50.3%).
Liver ultrasound found the following conditions within the patient population: heterogeneous parenchyma (85.4%), lobar redistribution (72.5%), and surface nodularity (65.6%). Cross-sectional imaging meanwhile detected the same features in 60.3%, 87%, and 84.9% of the patients, respectively.
Ultrasound achieved sensitivity values greater than 75% for all variables. However, specificity varied between variables. These included specificity values of 21% for heterogeneous parenchyma, 58% for lobar redistribution, and 85% for surface nodularity.
Also, liver ultrasound achieved a sensitivity of 89% and specificity of 73% in determining liver nodules, as well as substantial agreement (K = 0.64) with cross-sectional imaging. Finally, liver cirrhosis was diagnosed in 78% and 90% of the population by ultrasound and cross-sectional imaging, respectively.
Attend this session to see what else the team found.
