title: Hepatic phospholipids in alcoholic liver disease assessed by proton-decoupled 31P magnetic resonance spectroscopy.
abstract: OBJECTIVE
  Alteration of the phospholipid composition of hepatic biomembranes may be one mechanism of alcoholic liver disease (ALD). We applied proton-decoupled (31)P magnetic resonance spectroscopic imaging ({(1)H}-(31)P MRSI) to 40 patients with ALD and to 13 healthy controls to confirm that metabolic alterations in hepatic phospholipid intermediates could be detected non-invasively.
  
  
  METHODS
  All patients underwent liver biopsy. Specimens were scored in non-cirrhosis [fatty liver (n=3), alcoholic hepatitis (n=2), fibrosis (n=4), alcoholic hepatitis plus fibrosis (n=16)], and cirrhosis (n=15). {(1)H}-(31)P spectra were collected on a clinical 1.5-Tesla MR system and were evaluated by calculating signal intensity ratios of hepatic phosphomonoester (PME), phosphodiester (PDE), phosphoethanolamine (PE), phosphocholine (PC), glycerophosphorylethanolamine (GPE), and glycerophosphorylcholine (GPC) resonances.
  
  
  RESULTS
  The signal intensity ratio GPE/GPC was significantly elevated in cirrhotic (1.19+/-0.22; P=0.002) and non-cirrhotic ALD patients (1.01+/-0.13; P=0.006) compared to healthy controls (0.68+/-0.04), while PE/PC and PME/PDE were significantly elevated in cirrhotic ALD patients compared to controls (1.68+/-0.60 vs. 0.97+/-0.31; P=0.02, and 0.38+/-0.02 vs. 0.25+/-0.01; P=0.002, respectively) and non-cirrhotic patients.
  
  
  CONCLUSIONS
  The data support that {(1)H}-(31)P MRSI appears to distinguish cirrhotic from non-cirrhotic ALD patients and confirms changes in hepatic phospholipid metabolism observed in an animal model.
authors.affiliation: Department of Diagnostic Radiology, University Hospital, Eberhard-Karls University, Tübingen, Germany.
authors.forename: Heinz-Peter Wilhelm
authors.initials: HP
authors.lastname: Schlemmer
authors.forename: Tanja
authors.initials: T
authors.lastname: Sawatzki
authors.forename: Steffen
authors.initials: S
authors.lastname: Sammet
authors.forename: Ines
authors.initials: I
authors.lastname: Dornacher
authors.forename: Peter
authors.initials: P
authors.lastname: Bachert
authors.forename: Gerhard
authors.initials: G
authors.lastname: van Kaick
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Waldherr
authors.forename: Helmut Karl
authors.initials: HK
authors.lastname: Seitz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000378:metabolism; D008108:Liver Diseases, Alcoholic / Q000000981:diagnostic imaging* / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000378:metabolism*; D010759:Phosphorus Isotopes; D011522:Protons; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity
chemical_list: D010743:Phospholipids; D010759:Phosphorus Isotopes; D011522:Protons