摘要
AIM: To assess the functional status and etiology of liver cirrhosis by quantitative 31p magnetic resonance spectroscopy (MRS).METHODS: A total of 80 patients with liver cirrhosis of different etiology and functional status described by Child-Pugh score were examined and compared to 11 healthy volunteers. MR examination was performed on a 1.5 T imager using a 1H/31P surface coil by the 2D chemical shift imaging technique.Absolute concentrations of phosphomonoesters (PME),phosphodiesters (PDE), inorganic phosphate (Pi) and adenosine triphosphate (ATP) were measured.RESULTS: MRS changes reflected the degree of liver dysfunction in all the patients as well as in individual etiological groups. The most important change was a decrease of PDE. It was possible to distinguish alcoholic,viral and cholestatic etiologies based on MR spectra.Alcoholic and viral etiology differed in PDE (alcoholic,viral, controls: 6.5±2.3, 6.5±3.1, 10.8±2.7 mmol/L,P＜0.001) and ATP (alcoholic, viral, controls: 2.9±0.8, 2.8±0.9, 3.7±1.0 mmol/L, P＜0.01) from the control group.Unlike viral etiology, patients with alcoholic etiology also differed in Pi (alcoholic, controls: 1.2±0.4, 1.6±0.6mmol/L, P＜0.05) from controls. No significant changes were found in patients with cholestatic disease and controls; nevertheless, this group differed from both alcoholic and viral groups (cholestatic, alcoholic, viral: 9.4±2.7, 6.5±2.3, 6.5±3.1 mmol/L, P＜0.005) in PDE.CONCLUSION: 31p MRS can significantly help in noninvasive separation of different etiological groups leading to liver cirrhosis. In addition, MRS changes reflect functional liver injury.
AIM： To assess the functional status and etiology of liver cirrhosis by quantitative 31p magnetic resonance spectroscopy （MRS）.
METHODS： A total of 80 patients with liver cirrhosis of different etiology and functional status described by Child-Pugh score were examined and compared to 11 healthy volunteers. MR examination was performed on a 1.5 T imager using a ^1H/^31P surface coil by the 2D chemical shift imaging technique. Absolute concentrations of phosphomonoesters （PME）, phosphodiesters （PDE）, inorganic phosphate （Pi） and adenosine triphosphate （ATP） were measured. RESULTS： MRS changes reflected the degree of liver dysfunction in all the patients as well as in individual etiological groups. The most important change was a decrease of PDE. It was possible to distinguish alcoholic, viral and cholestatic etiologies based on MR spectra. Alcoholic and viral etiology differed in PDE （alcoholic, viral, controls： 6.5±2.3, 6.5±3.1, 10.8±2.7 mmol/L, P〈0.001） and ATP （alcoholic, viral, controls： 2.9±0.8, 2.8 ±0.9, 3.7±1.0 mmol/L, P〈0.01） from the control group. Unlike viral etiology, patients with alcoholic etiology also differed in Pi （alcoholic, controls： 1.2±0.4, 1.6±0.6 mmol/L, P〈0.05） from controls. No significant changes were found in patients with cholestatic disease and controls; nevertheless, this group differed from both alcoholic and viral groups （cholestatic, alcoholic, viral： 9.4 ±2.7, 6.5±2.3, 6.5±3.1 mmol/L, P〈0.005） in PDE.
CONCLUSION： ^31p MRS can significantly help in noninvasive separation of different etiological groups leading to liver cirrhosis. In addition, MRS changes reflect functional liver injury.
基金
Supported by grant from Ministry of Health IGA 7853-3, and MZO 00023001, Czech Republic
关键词
病原学
肝硬化
MR
光谱学
Liver cirrhosis
^ 31p MR spectroscopy
Absolute concentration
Child-Pugh score
Etiology
