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Alcoholic liver disease: quantitative image-guided P-31 MR spectroscopy
D J Meyerhoff1, M D Boska, A M Thomas
1Magnetic Resonance Unit, Veterans Administration Medical Center, San Francisco, CA 94121.
Radiology
|November 1, 1989
Summary
Quantitative phosphorus-31 magnetic resonance (MR) spectroscopy revealed decreased hepatic metabolite concentrations in alcoholic liver disease. Intracellular pH measurements using MR spectroscopy can differentiate alcoholic hepatitis from cirrhosis.
Area of Science:
- Hepatology
- Medical Imaging
- Biochemistry
Background:
- Alcoholic liver disease encompasses alcoholic hepatitis and cirrhosis, characterized by significant liver damage.
- Non-invasive biomarkers are crucial for assessing disease severity and differentiating between stages.
- Magnetic resonance (MR) spectroscopy offers a potential method for in vivo metabolic profiling of the liver.
Purpose of the Study:
- To investigate hepatic metabolite concentrations and intracellular pH in patients with alcoholic liver disease using phosphorus-31 (P-31) MR spectroscopy.
- To compare metabolic profiles between alcoholic hepatitis, alcoholic cirrhosis, and healthy controls.
- To determine the utility of P-31 MR spectroscopy in distinguishing between alcoholic hepatitis and cirrhosis.
Main Methods:
- P-31 MR spectroscopy was performed on the livers of patients with alcoholic hepatitis (n=10), alcoholic cirrhosis (n=9), viral hepatitis B (n=3), and healthy controls (n=21).
- A hydrogen-1 (H-1) MR image-guided technique (ISIS) was employed for selective spectral acquisition from the liver.
- Absolute molar concentrations of hepatic phosphomonoesters, phosphodiesters, inorganic phosphate, and adenosine triphosphate were quantified.
Main Results:
- Hepatic metabolite ratios did not significantly differ between alcoholic liver disease patients and healthy subjects.
- Absolute concentrations of hepatic metabolites were reduced by 25%-46% in alcoholic hepatitis and 13%-50% in alcoholic cirrhosis compared to controls.
- Hepatic intracellular pH was 7.4 in healthy subjects, more acidic in alcoholic cirrhosis, and more alkaline in alcoholic hepatitis.
Conclusions:
- Hepatic metabolite ratios are not sensitive indicators of alcoholic liver disease.
- Quantitative P-31 MR spectroscopy can non-invasively detect metabolic alterations in alcoholic liver disease.
- Hepatic intracellular pH measured by MR spectroscopy may differentiate between alcoholic hepatitis and cirrhosis.