In vivo 31P magnetic resonance spectroscopy in liver cirrhosis: assessment of phosphorus metabolites according to hepatic dysfunction

To assess the spectral alteration of phosphorus metabolities in patients with liver cirrhosis and compare energy metabolites with clinical grades using 31P MR spectra localized by two-dimensional chemical shift imaging. In 15 normal (control) subjects and 12 patients with liver cirrhosis, 31P MR spectroscopy was undertaken. Patients were divided into two groups, namely 'mild cirrhosis'(Child A, n=3D5) and 'severe cirrhosis' (Child B and C, n=3D7) according to disease severity, as assessed by Child-Hugh's classification. In vivo 31P MR spectroscopy was performed on a 1.5-T system (Magnetom Vision;Erlangen, Germany), usin a surface coil. Peak areas of phosphomonoester(PME), inorganic phosphate (Pi), phosphodiester (PDE), and γ-, α- and β-ATP were defined. Peak areas of phosphorous metabolites in the spectra were expressed as values of PME/β-ATP, PDE/β-ATP, PME/ATP, and PME/PDE. The values of PME/β-ATP, PDE/β-ATP, PME/ATP, and PME/PDE between control subjects and patients with liver cirrhosis were significantly different. With impaired hepatic dysfunction, PME increased as PDE decreased. In patients with severe cirrhosis, the values of PME/β-ATP and PME/ATP were significantly higher than those of patients with mild cirrhosis. In patients with liver cirrhosis, peak areas of PME, were significantly higher, and this might reflect the severity of hepatic dysfunction. PME/β-ATP and PME/ATP valves appear predict the severity of cirrhosis