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Using T1 mapping in cardiovascular magnetic resonance to assess congestive hepatopathy
Isabel Kazour1,2, Suraj D Serai3,4, Stavra A Xanthakos5
1Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
Insights
Quantitative T1 cardiovascular magnetic resonance (CMR) imaging can calculate liver extracellular volume (ECV). This method shows potential for monitoring liver fibrosis progression in patients with heart conditions.
Area of Science:
- Cardiovascular Magnetic Resonance Imaging
- Hepatology
- Medical Imaging
Background:
- Congestive hepatopathy (CH) is a liver condition resulting from impaired cardiac function.
- Accurate assessment of liver fibrosis progression is crucial for managing chronic liver disease.
- Non-invasive imaging techniques are needed to evaluate liver changes in patients with varying cardiac conditions.
Purpose of the Study:
- To evaluate the utility of quantitative T1 cardiovascular magnetic resonance (CMR) imaging for calculating liver extracellular volume (ECV).
- To assess liver ECV in patients with normal cardiac function, Tetralogy of Fallot (TOF) repair, and Fontan palliation.
- To determine if T1 mapping can track liver fibrosis progression in patients with CH.
Main Methods:
- Retrospective analysis of CMR scans from 172 subjects across three cohorts.
- Utilized modified look-locker inversion recovery (MOLLI) T1 mapping pre- and post-gadolinium-based contrast agent (GBCA) injection.
- Calculated liver ECV by measuring T1 changes in liver and blood pool pixel intensity data.
Main Results:
- Significant differences in liver native T1 and ECV were observed between normal cardiac function and Fontan palliation groups (p < 0.01).
- Quantitative T1 CMR imaging successfully calculated liver ECV in patients with varying degrees of CH.
- T1 mapping demonstrated potential for assessing liver changes related to cardiac dysfunction.
Conclusions:
- Quantitative T1 CMR imaging is a viable method for calculating liver ECV.
- This technique can be used to monitor the progression of liver fibrosis in patients with CH.
- T1 mapping shows promise for improving the diagnosis and management of chronic liver disease and fibrosis.
Abstract:
The goal of this study was to assess the ability of quantitative T1 cardiovascular magnetic resonance (CMR) imaging to calculate liver extracellular volume (ECV) in patients with varying degrees of congestive hepatopathy (CH). T1 measurements and ECV calculations were performed retrospectively in three cohorts of patients: normal cardiac function, tetralogy of fallot (TOF) repair and Fontan palliation. All CMR studies included modified look-locker inversion recovery (MOLLI) T1 mapping scans performed pre- and post-injection of a gadolinium-based contrast agent (GBCA). Pixel intensity data were manually collected from images of the liver and cardiac blood pool to determine contrast-induced changes in T1 for liver and blood. These data were then used to compute liver ECV. 172 subjects were included in the study. Of these, 140 subjects were normal cardiac function patients, 16 were TOF repair patients and 16 patients were with Fontan palliation. A statistically significant difference in both the liver native T1 and ECV measurements was found between patients with normal cardiac function vs. Fontan palliation patients (p < 0.01). Our data indicate that measuring T1 maps both pre- and post-GBCA injection within CMR scan session can be used to follow progression of liver fibrosis. This technique has the potential to improve diagnosis and treatment of patients with chronic liver disease and liver fibrosis.
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