{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:42:55Z","timestamp":1788514975410,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Many patients develop Fontan\u2010associated liver disease (FALD) after undergoing the Fontan procedure\u2014a surgical treatment for congenital heart disease such as single ventricle\u2014owing to changes in venous pressure and cardiac output. Liver biopsy is the gold standard for diagnosing FALD, but has limitations. Magnetic resonance elastography (MRE) is a popular non\u2010invasive method for evaluating liver stiffness and fibrosis in FALD; however, no unified view exists. This study aimed to assess the usefulness of MRE in evaluating the pathophysiology of FALD, including its correlation with cardiovascular parameters and histological findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>This retrospective cohort study included 22 patients with FALD who underwent MRE at Yokohama City University Hospital. Patients with other liver diseases or a history of heavy alcohol consumption were excluded. Liver biopsies were assigned a congestive hepatic fibrosis score (CHFS). Liver stiffness was measured using MRE, and hemodynamic data were obtained using cardiac catheterization. The correlation between MRE\u2010based liver stiffness and clinical, laboratory, and pathological findings was analyzed.<\/jats:p><jats:p>Patients' median age was 21.5\u2009years, and the Fontan procedure was performed 16.3\u2009years (mean) ago. Biochemical findings showed elevated gamma\u2010glutamyl transpeptidase (GGT) levels. Mean liver stiffness measured using MRE was high (5.3\u2009kPa), which significantly correlated with CHFS stage of liver fibrosis, and also correlated with GGT levels, fibrosis 4 index, and central venous pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MRE seems a promising non\u2010invasive tool for liver fibrosis evaluation in FALD. However, it may also reflect hepatic congestion. Further studies are needed to establish its clinical utility and standard cutoff values.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.70274","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T05:59:43Z","timestamp":1757051983000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy of Magnetic Resonance Elastography in Fontan\u2010Associated Liver Disease"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7650-0699","authenticated-orcid":false,"given":"Michihiro","family":"Iwaki","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7240-4851","authenticated-orcid":false,"given":"Takashi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4327-5167","authenticated-orcid":false,"given":"Naohiro","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumi","family":"Saiki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology National Hospital Organization Yokohama Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koki","family":"Nagai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology National Hospital Organization Yokohama Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6923-365X","authenticated-orcid":false,"given":"Asako","family":"Nogami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Yokohama City University Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Koyama","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Yokohama City University Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Utsunomiya","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Yokohama City University Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6263-1436","authenticated-orcid":false,"given":"Atsushi","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2342-1871","authenticated-orcid":false,"given":"Masato","family":"Yoneda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Yokohama City University Graduate School of Medicine  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)40598-9"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.26.3.240"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.748566"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.738559"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951113001650"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.01.993"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12358"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-305723"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2015.04.012"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)39097-X"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2007.052365"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2015.40"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.045"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2016.05.016"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.23731"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.09.046"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.14026"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2015.04.020"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12144"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.01.108"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/cld.681"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-S081"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-019-0284-9"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.5551\/jat.E537"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001250"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32302"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2016.02.002"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy620"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-020-02291-5"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12159"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.201772"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26631"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.17-349"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.094516"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-017-1181-9"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1727-1"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.07.013"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-024-03276-8"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2022.06.016"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.03.477"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000580"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.24496"},{"key":"e_1_2_11_44_1","first-page":"465","article-title":"Studies on the Mechanism of Gamma\u2010Glutamyltranspeptidase Elevation in Serum\u2013Concerning Its Hydrophobic and Hydrophilic Forms","volume":"78","author":"Nagatomo Y.","year":"1987","journal-title":"Fukuoka Igaku Zasshi"},{"key":"e_1_2_11_45_1","first-page":"7","article-title":"Serum Activity of Gamma\u2010Glutamyltranspeptidase, Adult and Fetal Forms in Patients With Compensated and Decompensated Forms of Alcoholic Cirrhosis","volume":"32","author":"Pereira A. A.","year":"1986","journal-title":"AMB; Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.14093"}],"container-title":["JGH Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.70274","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T08:56:16Z","timestamp":1760691376000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgh3.70274"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":45,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/jgh3.70274"],"URL":"https:\/\/doi.org\/10.1002\/jgh3.70274","archive":["Portico"],"relation":{},"ISSN":["2397-9070","2397-9070"],"issn-type":[{"value":"2397-9070","type":"print"},{"value":"2397-9070","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-04-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70274"}}