Liver Cancer
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2005; 11(44): 6926-6931
Published online Nov 28, 2005. doi: 10.3748/wjg.v11.i44.6926
Etiology and functional status of liver cirrhosis by 31P MR spectroscopy
Monika Dezortova, Pavel Taimr, Antonin Skoch, Julius Spicak, Milan Hajek
Monika Dezortova, Antonin Skoch, Milan Hajek: MR Unit, Department of Diagnostic and Interventional Radiology; Institute for Clinical and Experimental Medicine, Prague, Czech Republic
Pavel Taimr, Julius Spicak: Department of Hepatogastroenterology; Institute for Clinical and Experimental Medicine, Prague, Czech Republic
Author contributions: All authors contributed equally to the work.
Supported by grant from Ministry of Health IGA 7853-3, and MZO 00023001, Czech Republic
Correspondence to: Monika Dezortova, PhD, MR-Unit, ZRIR, IKEM, Videnska 1958/9, 140 21 Prague 4, Czech Republic.
Telephone: +420-241717729 Fax: +420-241717729
Received: March 3, 2005
Revised: April 5, 2005
Accepted: April 8, 2005
Published online: November 28, 2005

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 non-invasive separation of different etiological groups leading to liver cirrhosis. In addition, MRS changes reflect functional liver injury.

Keywords: Liver cirrhosis, 31P MR spectroscopy, Absolute concentration, Child-Pugh score, Etiology