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The mechanisms and disease development are unclear and early secondary liver cancer is a concern. This study will describe hepatic imaging findings in a national cohort of adolescents with Fontan circulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The patients prospectively underwent abdominal contrast enhanced magnetic resonance imaging (MRI) including diffusion-weighted imaging. Images were assessed for criteria of fibrosis\n                      <jats:italic>\/<\/jats:italic>\n                      cirrhosis including characterization of hepatic nodules. These nodules were in addition, assessed by ultrasonography (US). Nodules\u2009\u2265\u20091\u00a0cm were investigated and monitored to evaluate malignant transformation. Clinical and hepatic serological data were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-six patients, median age of 16.5\u00a0years (15.4\u201317.9\u00a0years) were enrolled. All patients underwent US examination and MRI was performed in 35\/46 patients. On MRI, 60% had hepatomegaly and 37% had signs of fibrosis\/cirrhosis. Seven patients had together 13 nodules\u2009\u2265\u20091\u00a0cm in diameter. Only 4\/13 (17%) where seen on US. Nodules had variable MRI signal characteristics including hepatobiliary contrast enhancement and two nodules revealed portal venous phase \u2018wash-out\u2019 on the first examination. No further imaging signs of malignancy were revealed during the follow-up period of median 24.4 (7\u201342) months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The majority of adolescents with Fontan circulation had imaging findings of fibrosis\/cirrhosis of varying severity. US had low detection rate of hepatic nodules compared to MRI. The imaging work-up before transition to adult cardiology care did not reveal findings suggestive of malignancy. However, the high prevalence of Fontan-associated liver disease calls for surveillance strategies even in childhood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00261-021-02994-0","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T05:02:52Z","timestamp":1615352572000},"page":"3205-3216","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Spectrum of Fontan-associated liver disease assessed by MRI and US in young adolescents"],"prefix":"10.1007","volume":"46","author":[{"given":"Karl Julius","family":"Thrane","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lil Sofie Ording","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrine Ryd\u00e9n","family":"Suther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian Stien","family":"Thomassen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Holmstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Thaulow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runar","family":"Almaas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"M\u00f6ller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5990-1781","authenticated-orcid":false,"given":"Charlotte","family":"de Lange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,10]]},"reference":[{"key":"2994_CR1","doi-asserted-by":"publisher","unstructured":"Akintoye E, Miranda WR, Veldtman GR, Connolly HM, Egbe AC (2019) National trends in Fontan operation and in-hospital outcomes in the USA. 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