Dezortova Monika, Taimr Pavel, Skoch Antonin, Spicak Julius, Hajek Milan
MR-Unit, Department of Diagnostic and Interventional Radiology; Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
World J Gastroenterol. 2005 Nov 28;11(44):6926-31. doi: 10.3748/wjg.v11.i44.6926.
To assess the functional status and etiology of liver cirrhosis by quantitative (31)P magnetic resonance spectroscopy (MRS).
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 (1)H/(31)P 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.
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.
(31)P MRS can significantly help in non-invasive separation of different etiological groups leading to liver cirrhosis. In addition, MRS changes reflect functional liver injury.
通过定量（31）P磁共振波谱（MRS）评估肝硬化的功能状态和病因。
共检查了80例不同病因和根据Child-Pugh评分确定功能状态的肝硬化患者，并与11名健康志愿者进行比较。使用（1）H/（31）P表面线圈，通过二维化学位移成像技术在1.5T成像仪上进行磁共振检查。测量磷酸单酯（PME）、磷酸二酯（PDE）、无机磷酸盐（Pi）和三磷酸腺苷（ATP）的绝对浓度。
MRS变化反映了所有患者以及各个病因组的肝功能障碍程度。最重要的变化是PDE降低。根据磁共振波谱可以区分酒精性、病毒性和胆汁淤积性病因。酒精性和病毒性病因在PDE（酒精性、病毒性、对照组：6.5±2.3、6.5±3.1、10.8±2.7mmol/L，P<0.001）和ATP（酒精性、病毒性、对照组：2.9±0.8、2.8±0.9、3.7±1.0mmol/L，P<0.01）方面与对照组不同。与病毒性病因不同，酒精性病因患者的Pi（酒精性、对照组：1.2±0.4、1.6±0.6mmol/L，P<0.05）也与对照组不同。胆汁淤积性疾病患者和对照组未发现明显变化；然而，该组在PDE方面与酒精性和病毒性组均不同（胆汁淤积性、酒精性、病毒性：9.4±2.7、6.5±2.3、6.5±3.1mmol/L，P<0.005）。
（31）P MRS有助于显著无创地区分导致肝硬化的不同病因组。此外，MRS变化反映了肝脏功能损伤。
