Usefulness of hepatic CT attenuation values in assessment of Fontan-associated liver disease progression: a comparative study with Model of End-stage Liver Disease Excluding International Normalized Ratio scores.

IF 0.9 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiology in the Young Pub Date : 2025-04-01 Epub Date: 2025-02-13 DOI:10.1017/S1047951125000393
Yosuke Kugo, Takashi Kido, Takuji Watanabe, Toshiaki Nagashima, Masaki Taira, Daisuke Yoshioka, Kazuo Shimamura, Shigeru Miyagawa
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引用次数: 0

Abstract

Fontan-associated liver disease leads to liver cirrhosis and hepatocellular carcinoma, worsening patient prognosis. Although the Model of End-Stage Liver Disease Excluding International Normalized Ratio score correlates with disease severity, precise prediction methods remain elusive. The hepatic computed tomography (CT) attenuation is used to assess steatohepatitis, which may offer insight into disease progression. This study aimed to determine the usefulness of hepatic CT attenuation values in assessing Fontan-associated liver disease progression. All post-Fontan patients with >20 years' follow-up data between 1980 and 2021 were reviewed. We set five regions of interest with a 20-mm-diameter circle in the peripheral region of the liver to obtain minimum, maximum, mean, and standard deviation of the CT attenuation values, which were adjusted to those of the aorta. The impact of hepatic CT attenuation values on cirrhosis development was evaluated. Cox regression revealed significant associations between adjusted minimum (hazard ratio: 0.01 [0.00-0.02, p < 0.01), adjusted maximum (hazard ratio: 159 [4.34-5831, p < 0.01]), and standard deviation (hazard ratio: 1.89 [1.29-2.76, p < 0.01]) and Model of End-Stage Liver Disease Excluding International Normalized Ratio score (hazard ratio: 1.2 [1.02-1.43, p = 0.03]) with cirrhosis. In cirrhosis cases, the adjusted minimum value exhibited significant longitudinal alteration prior to cirrhosis (p < 0.01), whereas Model of End-Stage Liver Disease Excluding International Normalized Ratio scores remained stable. The hepatic CT attenuation values were associated with cirrhosis development and the longitudinal changes are more sensitive than the Model of End-Stage Liver Disease Excluding International Normalized Ratio score.

肝CT衰减值评估fontan相关肝病进展的有效性:与终末期肝病模型(不含国际标准化比值评分)的比较研究
丰坦相关肝病可导致肝硬化和肝细胞癌,使患者预后恶化。尽管终末期肝病模型排除国际标准化比率评分与疾病严重程度相关,但精确的预测方法仍然难以捉摸。肝脏计算机断层扫描(CT)衰减用于评估脂肪性肝炎,这可能有助于了解疾病进展。本研究旨在确定肝脏CT衰减值在评估丰坦相关肝脏疾病进展中的有效性。回顾了1980年至2021年间所有fontan后患者20年的随访数据。我们在肝脏外周区域以直径20mm的圆圈设置5个感兴趣区域,获得CT衰减值的最小值、最大值、平均值和标准差,并调整为主动脉的衰减值。评估肝脏CT衰减值对肝硬化发展的影响。Cox回归显示校正最小值(风险比:0.01 [0.002 -0.02,p < 0.01)、校正最大值(风险比:159 [4.34-5831,p < 0.01])、标准差(风险比:1.89 [1.29-2.76,p < 0.01])和终末期肝病模型剔除国际标准化比值评分(风险比:1.2 [1.02-1.43,p = 0.03])与肝硬化之间存在显著相关性。在肝硬化患者中,调整后的最小值在肝硬化前表现出显著的纵向变化(p < 0.01),而终末期肝病模型(不包括国际标准化比值)评分保持稳定。肝脏CT衰减值与肝硬化发展相关,纵向变化比终末期肝病模型(不含国际标准化比值)评分更敏感。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cardiology in the Young
Cardiology in the Young 医学-小儿科
CiteScore
1.70
自引率
10.00%
发文量
715
审稿时长
4-8 weeks
期刊介绍: Cardiology in the Young is devoted to cardiovascular issues affecting the young, and the older patient suffering the sequels of congenital heart disease, or other cardiac diseases acquired in childhood. The journal serves the interests of all professionals concerned with these topics. By design, the journal is international and multidisciplinary in its approach, and members of the editorial board take an active role in the its mission, helping to make it the essential journal in paediatric cardiology. All aspects of paediatric cardiology are covered within the journal. The content includes original articles, brief reports, editorials, reviews, and papers devoted to continuing professional development.
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