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Prior and subsequent cross-sectional imaging of the liver was also reviewed for comparison. Continuous variables were expressed as mean (standard deviation) or median (range) where appropriate. Comparisons were made between current patient age and number of years since Fontan completion using a standard TRIB1 Mann�CWhitney test. Correlations between variables were assessed with Spearman's correlation coefficient (rs). The level of statistical significance was set at P 0.75, fair to good at 0.40 �� R �� 0.75, and poor at R BTK inhibitor of their clinical cardiac MRI examination were included in this study (17 study cases; one patient was scanned twice in the time period). The age range of the cohort was 12 to 42 years (mean age: 23.3 years, and median age: 21 years), and the time since Fontan surgery (Fontan duration) ranged from 5 to 26 years (mean Fontan duration: 18.2 years, and median Fontan duration: 19 years). The study included seven patients with an atriopulmonary Fontan connection and nine patients with a total cavopulmonary connection. The MRE added less than 5 minutes to total scan duration in all cases, including preparation time. All patients had an elevated liver stiffness value, with a mean of 5.1 �� 1.0?kPa and ranging from 3.4?kPa to 8.2?kPa MK-2206 nmr (normal adult value is approximately 2.3?kPa).[14] In a patient with normal circulation, these values suggest the presence of mild to severe fibrosis.[14-16, 20] Representative MRE magnitude images and elastogram stiffness maps are shown in Figures?3 and 4. In the overall population, liver stiffness values trended upwards with increasing years since Fontan palliation (rs = 0.55, P = .023) (Figure?5). Also, a statistically significant difference was found in the liver stiffness between total cavopulmonary and atriopulmonary connection patients with a mean of 4.8 (range: 3.4�C5.8) kPa vs. 5.7 (range: 4.0�C8.2) kPa, respectively. This may primarily be due to the difference in the median Fontan duration between the two populations of 15.5 (5�C19.8) years vs. 25 (19�C27) years, respectively. On review of anatomic imaging, there were abnormalities of the liver parenchyma present in 14 of the 16 patients. These abnormalities ranged from heterogeneous enhancement of the liver, and other findings indicative of congestive hepatopathy,[21] to frank cirrhosis by imaging criteria.[22] Using a cutoff of 4.89?kPa between normal or mildy fibrotic livers (F0�C1) and moderate to severe fibrosis (F2�C4),[14] 11 of the 16 patients (69%) demonstrated liver stiffness, which would be in the moderate to severe range in patients with standard anatomy.