title: Phosphorus-31 MR spectroscopy in pediatric liver transplant recipients: a noninvasive assessment of graft status with correlation with liver function tests and liver biopsy.
abstract: OBJECTIVE
  Noninvasive in vivo hepatic phosphorus-31 MR spectroscopy has recently been shown to provide information about hepatic functional status. We sought to show the correlation of phosphorus-31 MR spectroscopy with blood biochemistry and liver biopsy results in pediatric patients after liver transplantation.
  
  
  METHODS
  Eleven pediatric transplant recipients (eight with good graft function, two with chronic hepatitis, and one with acute rejection) and four healthy control subjects were studied with in vivo 31P MR spectroscopy. Ratios of phosphomonoesters (PME) to total phosphorus (TP), phosphodiester (PDE) to TP, nucleotide triphosphates (NTP), inorganic phosphate (Pi), and intracellular acid-base status (pH) were measured. Liver function test (n = 11) and biopsy (n = 3) results were obtained for correlation with spectroscopic findings.
  
  
  RESULTS
  The eight patients with good graft function displayed spectral profiles similar to those of the healthy subjects, and no significant difference in the metabolic ratios of these patients compared with the control subjects was detected. Three patients with abnormal liver function and biopsy-proven hepatic complications showed elevated PME/TP ratios when compared with those of both the control subjects and the group with good graft function.
  
  
  CONCLUSIONS
  Phosphorus-31 MR spectroscopy is a feasible technique for the noninvasive assessment of host-related complications in pediatric patients after liver transplantation. Our preliminary data suggest that the technique may be integrated with MRI for the investigation of impaired liver function in transplant recipients when neither a biliary complication nor a vascular complication is identified.
authors.affiliation: Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Ngan Shing St., Shatin, Hong Kong SAR, China. winnie@med.cuhk.edu.hk
authors.forename: Winnie C W
authors.initials: WC
authors.lastname: Chu
authors.forename: Wynnie W M
authors.initials: WW
authors.lastname: Lam
authors.forename: Kim-Hung
authors.initials: KH
authors.lastname: Lee
authors.forename: David K W
authors.initials: DK
authors.lastname: Yeung
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sihoe
authors.forename: Chung-Kwong
authors.initials: CK
authors.lastname: Yeung
mesh_terms: D000293:Adolescent; D001706:Biopsy; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D010759:Phosphorus Isotopes; D011183:Postoperative Complications / Q000175:diagnosis*; D018709:Statistics, Nonparametric
chemical_list: D010759:Phosphorus Isotopes