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Abstract #5087

Lymphatic congestion in Fontan circulation demostrated by Gd-EOB-DTPA magnetic resonance lymphangiography

Akihiro Inoue1, Michinobu Nagao1, Atsushi Yamamoto1, Reiko Sakai1, Satoru Morita1, Masami Yoneyama2, and Shuji Sakai1
1Tokyo Women's Medical University Hospital, Tokyo, Japan, 2Philips health care, Tokyo, Japan

Synopsis

Keywords: Liver, Contrast Agent, Fontan circulation

Motivation: In the Fontan circulation, congestive liver and lymphatic congestion caused by elevated central venous pressure become permanent. These complications (called as FALD) are considered poor prognostic factors as Fontan-associated liver disease, and hyperplasia of abnormal lymphatic pathway have often been seen.

Goal(s): We attempt to depict abnormal lymphatic pathway using Gd-EOB-DTPA MRI and propose a classification of their severity.

Approach: MR lymphangiography was scanned using three-dimensional heavily T2-weighted imaging with a 3-tesla scanner 10 minutes after Gd-EOB-DTPA administration. Patients were classified into the three grades.

Results: MR lymphangiography with Gd-EOB-DTPA, demonstrates the localization and extent of the abnormal lymphatic pathways in Fontan circulation.

Impact: In the Fontan circulation, the higer the lymphangiographic grade using MR lymphangiography with Gd-EOB-DTPA was, the more the adverse events was seen. The lymphangiographic grade is associated with the adverse events in Fontan-associated liver disease.

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