Chronic hepatitis: in vivo proton MR spectroscopic evaluation of the liver and correlation with histopathologic findings.
Cho SG, Kim MY, Kim HJ, Kim YS, Choi W, Shin SH, Hong KC, Kim YB, Lee JH, Suh CH.: Radiology 2001 Dec;221(3):740-6
PURPOSE: To correlate the
in vivo hydrogen 1 ((1)H) magnetic resonance (MR) spectroscopic
features of the chronic hepatitis-involved liver with the histopathologic
stages of fibrosis. MATERIALS AND METHODS: Seventy-five patients
with chronic hepatitis were examined with (1)H MR spectroscopy,
which was performed in the right hepatic lobe. The peak areas
of glutamine and glutamate complex (Glx), phosphomonoesters (PME),
glycogen and glucose complex (Glyu), and lipid were measured on
the liver spectra. The histopathologic features were correlated
with the in vivo (1)H MR spectroscopic findings at each stage
of chronic hepatitis. Fifteen healthy volunteers also were included
as a control group. RESULTS: (1)H MR spectroscopy depicted Glx,
PME, Glyu, and lipid in all livers. In the normal livers, the
calculated mean (+/- SD) relative metabolite-to-lipid ratios of
Glx, PME, and Glyu were 0.14 +/- 0.04, 0.03 +/- 0.01, and 0.21
+/- 0.04, respectively. The mean value of each metabolite-to-lipid
ratio was significantly different between all stages of chronic
hepatitis, and with the exception of the mean ratio at the interval
between stages 0 and 1 (P > .05), the mean value increased
significantly with increasing stage (P < .05). A pronounced
peak was demonstrated at 3.9-4.1 ppm at (1)H MR spectroscopy of
all stages of chronic hepatitis except stage 0. CONCLUSION: The
increased Glx, PME, and Glyu levels relative to the lipid content
with chronic hepatitis indicated the severity of fibrosis and
thus were concordant with the histopathologic stages. In vivo
(1)H MR spectroscopy might be a substitute for liver biopsy in
the diagnosis and staging of chronic hepatitis.
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