The relationship between 31P magnetic resonance spectroscopy and the histopathology of livers of chronic viral hepatitis patients.1Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
AbstractOBJECTIVE: To investigate the correlations between 31P-magnetic resonance spectroscopy （MRS） findings and histopathological grading and staging of the livers of chronic viral hepatitis patients. METHODS: Thirty-one patients with chronic viral hepatitis and 18 healthy volunteers were enrolled for this study. All of them underwent routine MRI plain scan and 31P-MRS of their livers. Peak areas of PME, PDE, PCr, Pi, gamma-ATP, beta-ATP and alpha-ATP were calculated. The concentrations of the phosphorus compounds of their livers, including PME, PDE, PCr, Pi, gamma-ATP, beta-ATP and alpha-ATP were measured. Percutaneous liver biopsies were performed on all 31 patients 0 to 7 days after their 31P-MRS examinations. Biopsy specimens were scored for fibrosis and necroinflammation according to the Knodell histological activity index. According to their necroinflammation scores, the 31 patients were divided into groups: slight hepatitis （7 patients）, mild hepatitis （11）, moderate hepatitis （8） and severe hepatitis （5）. According to their fibrosis scores, the patients were divided into groups: no fibrosis （7 patients）, portal fibrosis （11）, bridging fibrosis （5） and cirrhosis （8）. RESULTS: The PME%, PDE% and PME/PDE of the hepatitis patients and of the control volunteers had significant statistical differences. The differences of PME%, PDE% and PME/PDE among different grades and stages also had statistical significance. When PME/PDE=0.78, 0.95 and 1.11 were set as the cut-off points for different grades of necroinflammation, and PME/PDE=0.79, 0.95 and 1.10 were set as the cut-off points for different stages of fibrosis, a sensitivity of 80.0%-87.5% and a specificity of 42.9%-72.7% were achieved. CONCLUSION: PME/PDE is a sensitive marker for diagnosing the severity of chronic viral hepatitis. A rise of PME/PDE in hepatitis patients represents an increase of synthesis and a decrease in the breakdown of hepatocytes. Zhonghua Gan Zang Bing Za Zhi. 2007 May;15（5）:338-41. PMID: 17524264 [PubMed - indexed for MEDLINE]
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