A comparison of 31P magnetic resonance spectroscopy and microbubble-enhanced ultrasound for characterizing hepatitis c-related liver disease

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http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2011.01455.x/abstract

A comparison of 31P magnetic resonance spectroscopy and microbubble-enhanced

ultrasound for characterizing hepatitis c-related liver disease

A. K. P. Lim1,

N. Patel1,2,

R. J. Eckersley1,

J. Fitzpatrick2,

M. M. E. Crossey2,

G. Hamilton2,

R. D. Goldin3,

H. C. 2,

W. Vennart4,

D. O. Cosgrove1,

S. D. -2

Article first published online: 4 APR 2011

DOI: 10.1111/j.1365-2893.2011.01455.x

© 2011 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Early View (Online Version of Record published before inclusion in an issue)

Summary.  We compared in vivo hepatic 31P magnetic resonance spectroscopy (31P

MRS) and hepatic vein transit times (HVTT) using contrast-enhanced ultrasound

with a microbubble agent to assess the severity of hepatitis C virus

(HCV)-related liver disease. Forty-six patients with biopsy-proven HCV-related

liver disease and nine healthy volunteers had 31P MRS and HVTT performed on the

same day. 31P MR spectra were obtained at 1.5 T. Peak areas were calculated for

metabolites, including phosphomonoesters (PME) and phosphodiesters (PDE).

Patients also had the microbubble ultrasound contrast agent, Levovist (2 g),

injected into an antecubital vein, and time-intensity Doppler ultrasound signals

of the right and middle hepatic veins were measured. The HVTT was calculated as

the time from injection to a sustained rise in Doppler signal 10% greater than

baseline. The shortest times were used for analysis. Based on Ishak histological

scoring, there were 15 patients with mild hepatitis, 20 with moderate/severe

hepatitis and 11 with cirrhosis. With increasing severity of disease, the

PME/PDE ratio was steadily elevated, while the HVTT showed a monotonic decrease.

Both imaging modalities could separate patients with cirrhosis from the mild and

moderate/severe hepatitis groups. No statistical difference was observed in the

accuracy of each test to denote mild, moderate/severe hepatitis and cirrhosis

(Fisher’s exact test P = 1.00). 31P MRS and HVTT show much promise as

noninvasive imaging tests for assessing the severity of chronic liver disease.

Both are equally effective and highly sensitive in detecting cirrhosis.