Feasibility, classification and potential clinical impact of non-invasive delineation of abdominal lymphatic vessels in patients following TCPC with T2 weighted MRI
Abstract Recent research in patients with functionally univentricular hearts (UVH) is focusing on pathologies of the lymphatic vessels. Morphology of the abdominal lymphatic vessels was analyzed by MRI in patients with UVH following total cavopulmonary connection (TCPC) and it was examined, if clini...
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Nature Portfolio
2024-11-01
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| Online Access: | https://doi.org/10.1038/s41598-024-81299-w |
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| author | Anja Hanser Michael Hofbeck Melanie Hofmeister Petros Martirosian Andreas Hornung Michael Esser Fritz Schick Thomas Küstner Renate Kaulitz Jörg Michel Konstantin Nikolaou Jürgen Schäfer Christian Schlensak Winfried Baden Johannes Nordmeyer Ludger Sieverding |
| author_facet | Anja Hanser Michael Hofbeck Melanie Hofmeister Petros Martirosian Andreas Hornung Michael Esser Fritz Schick Thomas Küstner Renate Kaulitz Jörg Michel Konstantin Nikolaou Jürgen Schäfer Christian Schlensak Winfried Baden Johannes Nordmeyer Ludger Sieverding |
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| description | Abstract Recent research in patients with functionally univentricular hearts (UVH) is focusing on pathologies of the lymphatic vessels. Morphology of the abdominal lymphatic vessels was analyzed by MRI in patients with UVH following total cavopulmonary connection (TCPC) and it was examined, if clinical and laboratory parameters correlate with changes after TCPC. We prospectively examined 33 patients at the age of 19.8 (14.6;30.2) years [median (Q1;Q3)] after TCPC (follow-up 14.3 years (9.7;24.9) with a heavily T2-weighted MRI sequence on a 3.0 T scanner. Examinations in coronal orientation were performed with respiratory gating, slice thickness 0.6 mm, TR 2400 ms, TE 692 ms, FoV 460 mm (covering thoracic and abdominal regions), scan time 14:41 min (13:18;16:30) after a solid meal and a cup of pineapple juice. The findings were classified according to delineation of abdominal lymphatic vessels. Type 1: <3 abdominal vessels (av) definable; type 2: 4–6 av definable; type 3: >6 av and/or oedematous changes or ascites. The results were correlated with parameters obtained at the annual routine check-up. Statistical analysis was performed using U-test and Chi-square test. Fifteen patients (group 1) showed type 3 lymphatic morphologies, two of which had ascites. Eighteen patients (group 2) showed lower grade morphologies (type 1–2). Image quality was rated considering the delineation of the common hepatic duct and did not differ between groups (p = 0.134). “Lymphatic burden” was automatically examined and was indexed to the number of delineated abdominal vessels and showed quantification according to the chosen categories type 1–3. Patients in group 1 were younger at MRI examination (17.4;14.3/18.9 vs. 26.2;18.2/32.3 years, p = 0.03). Superior cavopulmonary connection (SCPC) had been performed earlier in group 1 (9.9;7.9/25.5 vs. 29.2;13.7/66.6 months, p = 0.018). Laboratory examinations in group 1 showed lower levels for Immunoglobulin G (IgG), Lipase, α-Antitrypsin, Cystatin C and TSH. There were no significant differences for total protein, NTproBNP, lymphocytes or platelets. A history of chylothorax was present in 7/15 versus 2/18 p = 0.022. Protein-losing enteropathy (PLE) occurred in 4/15 versus 1/18 (p = 0.092). T2 weighted MRI is feasible for noninvasive delineation of abdominal lymphatic vessel in patients following TCPC. In the long-term follow-up, patients with more pronounced changes of the abdominal lymphatic vessels were younger at SCPC and were more likely to show a history of chylothorax and lower IgG values. |
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| spelling | doaj-art-6ca2d2e42fa84933850fdc083a3e3c7f2025-08-20T02:08:19ZengNature PortfolioScientific Reports2045-23222024-11-0114111110.1038/s41598-024-81299-wFeasibility, classification and potential clinical impact of non-invasive delineation of abdominal lymphatic vessels in patients following TCPC with T2 weighted MRIAnja Hanser0Michael Hofbeck1Melanie Hofmeister2Petros Martirosian3Andreas Hornung4Michael Esser5Fritz Schick6Thomas Küstner7Renate Kaulitz8Jörg Michel9Konstantin Nikolaou10Jürgen Schäfer11Christian Schlensak12Winfried Baden13Johannes Nordmeyer14Ludger Sieverding15Department of Pediatric Cardiology, University Children’s Hospital, University of TübingenDepartment of Pediatric Cardiology, University Children’s Hospital, University of TübingenDepartment of Pediatric Cardiology, University Children’s Hospital, University of TübingenSection on Experimental Radiology, University Hospital of TübingenDepartment of Pediatric Cardiology, University Children’s Hospital, University of TübingenDepartment of Diagnostic and Interventional Radiology, University Hospital of TübingenSection on Experimental Radiology, University Hospital of TübingenMedical Image and Data Analysis (MIDAS.lab), Department of Diagnostic and Interventional Radiology, University Hospital of TübingenDepartment of Pediatric Cardiology, University Children’s Hospital, University of TübingenDepartment of Pediatric Cardiology, University Children’s Hospital, University of TübingenDepartment of Diagnostic and Interventional Radiology, University Hospital of TübingenDepartment of Diagnostic and Interventional Radiology, University Hospital of TübingenDepartment of Cardiothoracic and Vascular Surgery, University Hospital of TübingenDepartment of Pediatric Cardiology, University Children’s Hospital, University of TübingenDepartment of Pediatric Cardiology, University Children’s Hospital, University of TübingenDepartment of Pediatric Cardiology, University Children’s Hospital, University of TübingenAbstract Recent research in patients with functionally univentricular hearts (UVH) is focusing on pathologies of the lymphatic vessels. Morphology of the abdominal lymphatic vessels was analyzed by MRI in patients with UVH following total cavopulmonary connection (TCPC) and it was examined, if clinical and laboratory parameters correlate with changes after TCPC. We prospectively examined 33 patients at the age of 19.8 (14.6;30.2) years [median (Q1;Q3)] after TCPC (follow-up 14.3 years (9.7;24.9) with a heavily T2-weighted MRI sequence on a 3.0 T scanner. Examinations in coronal orientation were performed with respiratory gating, slice thickness 0.6 mm, TR 2400 ms, TE 692 ms, FoV 460 mm (covering thoracic and abdominal regions), scan time 14:41 min (13:18;16:30) after a solid meal and a cup of pineapple juice. The findings were classified according to delineation of abdominal lymphatic vessels. Type 1: <3 abdominal vessels (av) definable; type 2: 4–6 av definable; type 3: >6 av and/or oedematous changes or ascites. The results were correlated with parameters obtained at the annual routine check-up. Statistical analysis was performed using U-test and Chi-square test. Fifteen patients (group 1) showed type 3 lymphatic morphologies, two of which had ascites. Eighteen patients (group 2) showed lower grade morphologies (type 1–2). Image quality was rated considering the delineation of the common hepatic duct and did not differ between groups (p = 0.134). “Lymphatic burden” was automatically examined and was indexed to the number of delineated abdominal vessels and showed quantification according to the chosen categories type 1–3. Patients in group 1 were younger at MRI examination (17.4;14.3/18.9 vs. 26.2;18.2/32.3 years, p = 0.03). Superior cavopulmonary connection (SCPC) had been performed earlier in group 1 (9.9;7.9/25.5 vs. 29.2;13.7/66.6 months, p = 0.018). Laboratory examinations in group 1 showed lower levels for Immunoglobulin G (IgG), Lipase, α-Antitrypsin, Cystatin C and TSH. There were no significant differences for total protein, NTproBNP, lymphocytes or platelets. A history of chylothorax was present in 7/15 versus 2/18 p = 0.022. Protein-losing enteropathy (PLE) occurred in 4/15 versus 1/18 (p = 0.092). T2 weighted MRI is feasible for noninvasive delineation of abdominal lymphatic vessel in patients following TCPC. In the long-term follow-up, patients with more pronounced changes of the abdominal lymphatic vessels were younger at SCPC and were more likely to show a history of chylothorax and lower IgG values.https://doi.org/10.1038/s41598-024-81299-wTCPCFontan CirculationAbdominal lymphatic vesselsT2-weighted imaging |
| spellingShingle | Anja Hanser Michael Hofbeck Melanie Hofmeister Petros Martirosian Andreas Hornung Michael Esser Fritz Schick Thomas Küstner Renate Kaulitz Jörg Michel Konstantin Nikolaou Jürgen Schäfer Christian Schlensak Winfried Baden Johannes Nordmeyer Ludger Sieverding Feasibility, classification and potential clinical impact of non-invasive delineation of abdominal lymphatic vessels in patients following TCPC with T2 weighted MRI Scientific Reports TCPC Fontan Circulation Abdominal lymphatic vessels T2-weighted imaging |
| title | Feasibility, classification and potential clinical impact of non-invasive delineation of abdominal lymphatic vessels in patients following TCPC with T2 weighted MRI |
| title_full | Feasibility, classification and potential clinical impact of non-invasive delineation of abdominal lymphatic vessels in patients following TCPC with T2 weighted MRI |
| title_fullStr | Feasibility, classification and potential clinical impact of non-invasive delineation of abdominal lymphatic vessels in patients following TCPC with T2 weighted MRI |
| title_full_unstemmed | Feasibility, classification and potential clinical impact of non-invasive delineation of abdominal lymphatic vessels in patients following TCPC with T2 weighted MRI |
| title_short | Feasibility, classification and potential clinical impact of non-invasive delineation of abdominal lymphatic vessels in patients following TCPC with T2 weighted MRI |
| title_sort | feasibility classification and potential clinical impact of non invasive delineation of abdominal lymphatic vessels in patients following tcpc with t2 weighted mri |
| topic | TCPC Fontan Circulation Abdominal lymphatic vessels T2-weighted imaging |
| url | https://doi.org/10.1038/s41598-024-81299-w |
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