Separation of advanced from mild fibrosis in diffuse liver disease using 31P magnetic resonance spectroscopy

Nonalcoholic Fatty Liver Disease: Detection of Elevated Nicotinamide Adenine Dinucleotide Phosphate with in Vivo 3.0-T31P MR Spectroscopy with Proton Decoupling

“…The inverse relationship of PDE to the degree of fi brosis in patients with NAFLD and those with cirrhosis found by Noren et al ( 27 ) also suggests a reduction in the membrane pool with advancing disease. This idea is consistent with commonly accepted hallmarks of failure of liver function, such as reduced synthesis of prealbumin and fi brinogenic factors, loss of serum alanine aminotransferase enzyme leak, and compared with that in control subjects and patients with NAFLD.…”

“…This idea is consistent with commonly accepted hallmarks of failure of liver function, such as reduced synthesis of prealbumin and fi brinogenic factors, loss of serum alanine aminotransferase enzyme leak, and compared with that in control subjects and patients with NAFLD. Also, the concentration of PDE was found to be inversely related to the degree of fi brosis when subjects with NAFLD and cirrhosis due to different causes were pooled together ( 27 ). In MR spectroscopy, observing accumulation of a compound can arise from enhanced synthesis or reduced degradation, or it can include a metabolic block where further use is hampered.…”

“…However, adding these metabolites did not improve the differentiation of patients with cirrhotic alcoholic liver disease from those with noncirrhotic alcoholic liver disease when compared with PME and PDE. Noren et al ( 27 ) found the PME/(PME + PDE) ratio was elevated in patients with cirrhosis Note.-Unless otherwise indicated, data are means, and data in parentheses are 95% confi dence intervals. For age, data are means, and data in parentheses are ranges.…”

Radiologic Assessment of Liver Fibrosis – Present and Future

“…These compositional indices differed between obese patients with and without hepatic steatosis. Indices of lipid composition using in vivo proton ( 31 P-based MRS has also shown promise as a method of assessing the degree of hepatic fibrosis, in particular through analysis of the phosphomonoester/phosphodiester (PME/PDE) ratio [124]. As the stage of fibrosis increases, the PME peak may represent extensive membrane remodeling due to elevated levels of cell membrane precursors (such as phosphocholine and phosphoethanolamine).…”

The Non-Invasive Liver Biopsy : Determining Hepatic Function in Diffuse and Focal LiverDisease

“…31 P-MRS has also been applied in hepatic applications (72,73) where the ratio of phosphomonoesters (PME) and phosphodiester (PDE), which reside in the cell membranes, are thought to be indicative of the regenerative processes of the hepatocytes in the damaged liver parenchyma (72). A variant of this is the PME/PDE ratio is the anabolic charge (AC; AC=PME/(PME+PDE), which has been shown to be affected in the fibrotic liver (74).…”