Detection of Passive Liver Congestion in Pericarditis Patients With Constrictive Physiology Using MR Relaxometry of the Liver.

Constrictive pericarditis is a common cause of right heart failure, characterized by increased filling pressures and passive liver congestion. As magnetic resonance (MR) T1 and T2 mapping allow quantification of liver relaxation times, we hypothesized liver mapping may allow depiction of passive liver congestion. We studied 45 pericarditis patients, of whom 25 presented constrictive physiology (CP+) and 20 normal physiology (CP-), and 30 control subjects. Pericarditis patients were predominantly male, but CP+ patients were on average 13 years older than CP- patients (p=0.003). Native T1 and T2 values as well as extracellular volume (ECV) values of the liver were significantly higher in CP+ than in CP- patients and controls, i.e. native T1: 765±102ms vs 581±56ms and 537±30ms; T2: 63±13ms vs 50±4ms and 46±4ms; ECV: 42±7% vs 31±3% and 30±3% control (all p<0.001). Using a cut-off right atrial (RA) pressure of >5 mm Hg to discriminate between normal and increased RA pressure, native T1 liver yielded the highest AUC (0.926) at ROC analysis with a sensitivity of 79.3% and specificity of 95.6%. Moreover, liver mapping showed excellent intra- and inter-reader agreement. In conclusion, liver mapping as part of a comprehensive cardiovascular MR exam is valuable to depict liver congestion in pericarditis patients.

Effect of combined treatment on indices of liver venous blood flow in chronic opisthorchosis patients

At chronic opisthorchosis, disorders of venous blood flow in liver are observed in color Doppler liver mapping. To improve venous blood flow indices and the functional state of the hepatobiliary system as a whole, combined treatment should include factors not only ensuring the antiparasitic, antiphlogistic, and cholagogic effect, but also improving liver hemodynamics. This problem can be solved by combination of measures including morning exercises, pine baths, intake of cholagogic herbs with the following transversal galvanization in the epigastric region, and background x-ray radiation.