ArticleJournal of ultrasound2026
Discordant 2D shear wave elastography values in post-Fontan patients with ascites: a potential interpretive pitfall.
Article in Journal of ultrasound, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Fontan-associated liver disease (FALD) may progress to portal hypertension, ascites, and nodular liver remodelling. Two-dimensional shear wave elastography (2D-SWE) can be performed in patients with ascites, but its reliability in this setting remains uncertain. We report two post-Fontan patients with ascites and nodular liver morphology on B-mode ultrasound who showed markedly discordant liver stiffness values. The pediatric patient had high stiffness (median 24.25 kPa; IQR/median 3.4%), whereas the adult patient with clinical decompensation, large-volume ascites, and pleural effusion had unexpectedly low stiffness (median 9.55 kPa; IQR/median 23.6%). These cases suggest that substantial ascites may contribute to misleading 2D-SWE measurements. In post-Fontan patients, elastography should be interpreted alongside acquisition quality metrics, morphology, and clinical findings.
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