HEPATIC P-31 MAGNETIC-RESONANCE SPECTROSCOPY IN PRIMARY BILIARY-CIRRHOSIS AND ITS RELATION TO PROGNOSTIC MODELS

Background-In vivo hepatic phosphorus-31 magnetic resonance spectrosco py (P-31 MRS) provides biochemical information about phosphorus metabo lism. Aim-To assess P-31 MRS as a prognostic marker in patients with p rimary biliary cirrhosis (PBC) in relation to the current clinical pro gnostic models. Patients and Methods-Twenty three patients with PBC of varying functional severity and 16 matched healthy volunteers were st udied using in vivo P-31 MRS. Spectra were acquired using a 1.5 T spec troscopy system. Peak area ratios of phosphomonoesters (PME), inorgani c phosphate (Pi), and phosphodiesters (PDE) and nucleotide triphosphat e (NTP) were calculated. Pugh score, Christensen prognostic index, and R value according to the Mayo model were calculated from the clinical data. Results-The PME/NTP, Pi/NTP, PME/PDE, and PME/Pi ratios and the PME signal height ratio (SHR) were significantly higher, while the PD E/NTP and PDE/SHR were significantly lower in PBC patients compared wi th healthy volunteers (p<0.01). Significant correlations were seen bet ween PME/Pi ratio and the prognostic index according to Christensen (r =0.63, p<0.001), R value according to the Mayo model (r=0.45, p<0.03), and with the Pugh score (r=0.55, p<0.007). Conclusions-This study sho ws that PME/Pi ratio obtained from P-31 MRS correlates well with all t hree of the commonly used models of prognosis in patients with PBC. A longitudinal study with larger number of patients is required to confi rm these findings and elucidate the biochemical changes underlying thi s phenomenon.