Yu Ri-Sheng, Hao Liang, Dong Fei, Mao Jian-Shan, Sun Jian-Zhong, Chen Ying, Lin Min, Wang Zhi-Kang, Ding Wen-Hong
Department of Internal Medicine, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
World J Gastroenterol. 2009 Jun 14;15(22):2723-30. doi: 10.3748/wjg.15.2723.
To compare the features of biochemical metabolic changes detected by hepatic phosphorus-31 magnetic resonance spectroscopy ((31)P MRS) with the liver damage score (LDS) and pathologic changes in rabbits and to investigate the diagnostic value of (31)P MRS in acute hepatic radiation injury.
A total of 30 rabbits received different radiation doses (ranging 5-20 Gy) to establish acute hepatic injury models. Blood biochemical tests, (31)P MRS and pathological examinations were carried out 24 h after irradiation. The degree of injury was evaluated according to LDS and pathology. Ten healthy rabbits served as controls. The 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. The relative quantities of phosphomonoesters (PME), phosphodiesters (PDE), inorganic phosphate (Pi) and adenosine triphosphate (ATP) were measured. The data were statistically analyzed.
(1) Relative quantification of phosphorus metabolites: (a) ATP: there were significant differences (P < 0.05) (LDS-groups: control group vs mild group vs moderate group vs severe group, 1.83 +/- 0.33 vs 1.55 +/- 0.24 vs 1.27 +/- 0.09 vs 0.98 +/- 0.18; pathological groups: control group vs mild group vs moderate group vs severe group, 1.83 +/- 0.33 vs 1.58 +/- 0.25 vs 1.32 +/- 0.07 vs 1.02 +/- 0.18) of ATP relative quantification among control group, mild injured group, moderate injured group, and severe injured group according to both LDS grading and pathological grading, respectively, and it decreased progressively with the increased degree of injury (r = -0.723, P = 0.000). (b) PME and Pi; the relative quantification of PME and Pi decreased significantly in the severe injured group, and the difference between the control group and severe injured group was significant (P < 0.05) (PME: LDS-control group vs LDS-severe group, 0.86 +/- 0.23 vs 0.58 +/- 0.22, P = 0.031; pathological control group vs pathological severe group, 0.86 +/- 0.23 vs 0.60 +/- 0.21, P = 0.037; Pi: LDS-control group vs LDS-severe group, 0.74 +/- 0.18 vs 0.43 +/- 0.14, P = 0.013; pathological control group vs pathological severe group, 0.74 +/- 0.18 vs 0.43 +/- 0.14, P = 0.005) according to LDS grading and pathological grading, respectively. (c) PDE; there were no significant differences among groups according to LDS grading, and no significant differences between the control group and experimental groups according to pathological grading. (2) The ratio of relative quantification of phosphorus metabolites: significant differences (P < 0.05) (LDS-moderate group and LDS-severe group vs LDS-control group and LDS-mild group, 1.94 +/- 0.50 and 1.96 +/- 0.72 vs 1.43 +/- 0.31 and 1.40 +/- 0.38) were only found in PDE/ATP between the moderate injured group, the severe injured group and the control group, the mild injured group. No significant difference was found in other ratios of relative quantification of phosphorus metabolites.
(31)P MRS is a useful method to evaluate early acute hepatic radiation injury. The relative quantification of hepatic ATP levels, which can reflect the pathological severity of acute hepatic radiation injury, is correlated with LDS.
比较兔肝脏磷-31磁共振波谱（(31)P MRS）检测的生化代谢变化特征与肝损伤评分（LDS）及病理变化，并探讨(31)P MRS在急性肝脏放射性损伤中的诊断价值。
30只兔接受不同辐射剂量（5 - 20 Gy）建立急性肝损伤模型。照射后24小时进行血液生化检测、(31)P MRS及病理检查。根据LDS和病理评估损伤程度。10只健康兔作为对照。采用二维化学位移成像技术，在1.5 T成像仪上使用(1)H/(31)P表面线圈进行磁共振检查。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）的相对含量。对数据进行统计学分析。
(1) 磷代谢产物的相对定量：(a) ATP：根据LDS分级和病理分级，对照组、轻度损伤组、中度损伤组和重度损伤组之间ATP相对定量均有显著差异（P < 0.05）（LDS分组：对照组vs轻度组vs中度组vs重度组，1.83 ± 0.33 vs 1.55 ± 0.24 vs 1.27 ± 0.09 vs 0.98 ± 0.18；病理分组：对照组vs轻度组vs中度组vs重度组，1.83 ± 0.33 vs 1.58 ± 0.25 vs 1.32 ± 0.07 vs 1.02 ± 0.18），且随损伤程度增加而逐渐降低（r = -0.723，P = 0.000）。(b) PME和Pi；重度损伤组PME和Pi的相对定量显著降低，对照组与重度损伤组之间差异显著（P < 0.05）（PME：LDS - 对照组vs LDS - 重度组，0.86 ± 0.23 vs 0.58 ± 0.22，P = 0.031；病理对照组vs病理重度组，0.86 ± 0.23 vs 0.60 ± 0.21，P = 0.037；Pi：LDS - 对照组vs LDS - 重度组，0.74 ± 0.18 vs 0.43 ± 0.14，P = 0.013；病理对照组vs病理重度组，0.74 ± 0.18 vs 0.43 ± 0.14，P = 0.005），分别根据LDS分级和病理分级。(c) PDE；根据LDS分级各组间无显著差异，根据病理分级对照组与实验组之间无显著差异。(2) 磷代谢产物相对定量比值：仅在中度损伤组、重度损伤组与对照组、轻度损伤组之间的PDE/ATP中发现显著差异（P < 0.05）（LDS - 中度组和LDS - 重度组vs LDS - 对照组和LDS - 轻度组，1.94 ± 0.50和1.96 ± 0.72 vs 1.43 ± 0.31和1.40 ± 0.38）。磷代谢产物其他相对定量比值未发现显著差异。
(31)P MRS是评估早期急性肝脏放射性损伤的有用方法。肝脏ATP水平的相对定量可反映急性肝脏放射性损伤的病理严重程度，与LDS相关。
