Fig. 2
From: Abdominal imaging findings in adult patients with Fontan circulation
Hepatic parenchymal change in CT and MRI in post-Fontan patients. a A 22-year-old woman with previous right atrial isomerism and pulmonary atresia. Axial CT image in portal venous phase demonstrates reticular regions of poor parenchymal enhancement in the periphery of the liver, which are prominent in the portal venous phase. Note that the stomach is located on the right side (asterisk) with left-sided liver and inferior vena cava (heterotoxy syndrome). b A 36-year-old woman with previous hypoplastic right ventricle syndrome. Axial CT image in portal venous phase demonstrates diffuse ill-defined inhomogeneous enhancement in the liver. Note that the caudate lobe hypertrophy with relative homogeneous attenuation (arrows). c-e A 22-year-old woman with previous hypoplastic right ventricle syndrome. Axial contrast-enhanced T1-weighted MR images with gadoxetate disodium–enhanced MR images obtained in the arterial phase (c), transitional phase (d) and hepatobiliary phase (e). c Multiple small arterial-enhancing foci (dotted arrows) with contrast agent retention in the hepatobiliary phase are scattered in the liver, in keeping with focal nodular hyperplasia-like nodules. d The arterial-enhancing foci show no delayed washout. Note that heterogeneous parenchymal enhancement is prominent in the right posterior segment of the liver (arrowheads). e The liver shows heterogeneously mildly decreased contrast material uptake, possibly reflecting decreased hepatic function and congestion. Also, low-signal intensity reticular bands with no contrast material retention (arrows) which may be due to dilated veins / fibrous septa and tend to spare regions around the portal triads while coming into direct contact with hepatic veins