³¹Phosphorus magnetic resonance spectroscopy of the liver for evaluating inflammation and fibrosis in autoimmune hepatitis

Abstract

Background: Liver biopsy is the gold standard in evaluating inflammation and fibrosis in autoimmune hepatitis.

Aims: In search of non-invasive follow-up tools in autoimmune hepatitis, we evaluated ³¹phosphorus magnetic resonance spectroscopy (³¹P MRS).

Methods: Twelve consecutive AIH patients (mean age 42.8 years, 10 women) underwent liver biopsy, routine laboratory liver function tests, which were compared to findings in ³¹P MRS and transient elastography (TE).

Results: Phosphoenolpuryvate (PEP) correlated with the grade of inflammation (r = 0.746, p = .005) and thromboplastin time (r = 0.592, p = .043). It also differentiated patients with active inflammation from patients without (t = 3.781, p = .009). There was no correlation between PEP and aminotransferase or immunoglobulin G levels.

The phosphoethanolamine (PE)/phosphocholine (PC) ratio, PE/glyserophosphoethanolamine (GPE) ratio and PC/[total phosphomonoester (PME) + phosphodiester (PDE)] ratios correlated with immunoglobulin G (r = 0.764, p = .006; r = 0.618, p = .043; and r= −0.636, p = .035, respectively).

PME/PDE and PE/GPE correlated with fibrosis (r = 0.668, p = .018 and r = 0.604, p = .037). PE/GPE also differentiated F3 from F0-2 patients (t = 3.810, p = .003).

Phosphorus metabolites did not correlate with TE results and TE did not correlate with liver histology or laboratory parameters.

Conclusions: ³¹P MRS seems to detect active inflammation and advanced fibrosis in AIH patients. TE was ineffective in fibrosis quantification.

Keywords:

• Autoimmune hepatitis
• liver histology
• magnetic resonance spectroscopy
• transient elastography
• fibrosis
• inflammation

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

Financial support has been received from Instrumentarium research foundation, Mary och Georg C. Ehrnrooth foundation and Orion research foundation.