31Phosphorus magnetic resonance spectroscopy of the liver for evaluating inflammation and fibrosis in autoimmune hepatitis. (3rd August 2017)

• Record Type: Journal Article
• Authors: Puustinen, Lauri; Hakkarainen, Antti; Kivisaari, Reetta; Boyd, Sonja; Nieminen, Urpo; Färkkilä, Martti; Lundbom, Nina; Arkkila, Perttu
• Is Part Of: Scandinavian journal of gastroenterology. Volume 52:Number 8(2017)
• Page Start: 886
• Page End: 892
• Publication Date: 2017-08-03
• Subjects: Autoimmune hepatitis -- liver histology -- magnetic resonance spectroscopy -- transient elastography -- fibrosis -- inflammation; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.1080/00365521.2017.1315738
• Languages: English
• ISSNs: 0036-5521

Abstract

Abstract: Background: Liver biopsy is the gold standard in evaluating inflammation and fibrosis in autoimmune hepatitis. Aims: In search of non-invasive follow-up tools in autoimmune hepatitis, we evaluated 31 phosphorus magnetic resonance spectroscopy ( 31 P MRS). Methods: Twelve consecutive AIH patients (mean age 42.8 years, 10 women) underwent liver biopsy, routine laboratory liver function tests, which were compared to findings in 31 P MRS and transient elastography (TE). Results: Phosphoenolpuryvate (PEP) correlated with the grade of inflammation ( r = 0.746, p = .005) and thromboplastin time ( r = 0.592, p = .043). It also differentiated patients with active inflammation from patients without ( t = 3.781, p = .009). There was no correlation between PEP and aminotransferase or immunoglobulin G levels. The phosphoethanolamine (PE)/phosphocholine (PC) ratio, PE/glyserophosphoethanolamine (GPE) ratio and PC/[total phosphomonoester (PME) + phosphodiester (PDE)] ratios correlated with immunoglobulin G ( r = 0.764, p = .006; r = 0.618, p = .043; and r = −0.636, p = .035, respectively). PME/PDE and PE/GPE correlated with fibrosis ( r = 0.668, p = .018 and r = 0.604, p = .037). PE/GPE also differentiated F3 from F0-2 patients ( t = 3.810, p = .003). Phosphorus metabolites did not correlate with TE results and TE did not correlate with liver histology or laboratory parameters. Conclusions: 31 P MRS seems to detect active inflammation and advanced fibrosis in AIH patients. TE was ineffective in fibrosis quantification.