Image localized 31P magnetic resonance spectroscopy of the human liver

Image localized 31P magnetic resonance (MR) spectroscopy of the liver was performed in twelve normal volunteers and seven patients with hepatic tumours. The tumours which were clearly imaged by proton MR could also be distinguished from normal tissue because of spectral differences. The malignant tumours had significantly elevated phosphomonoester/inorganic phosphate and phosphomonoester/beta-adenosine triphosphate ratios, probably due to elevated tumour concentrations of phosphocholine and phosphoethanolamine, which are intermediates in the synthesis of membrane phospholipids. The pH values of the malignant tumours were elevated compared to normal hepatic parenchyma. Liver spectra in two patients with the commonest benign hepatic neoplasm, cavernous haemangioma, differed from both normal tissue and the malignant tumours in having a very low signal/noise ratio but apparently normal relative levels of phosphomonoester.