Abstract:

To explore the value of in vivo 31phosphorus magnetic resonance spectroscopy (31PMRS) in detection of musculoskeletal metabolism for patients with liver cirrhosis. Methods31PMRS scanning with a single voxel on thigh skeletal muscle was carried out in 31 patients with liver cirrhosis and in 30 normal cases. Intracellular pH value (pHi) and some metabolic parameters including phosphomonoester (PME), phosphodiester (PDE), inorganic phosphate (Pi), phosphocreatine (PCr), γATP, βATP, αATP, and the ratios of Pi/ATP, PCr/ATP, PCr/PME, PCr/PDE, PCr/Pi, PME/ATP, PME/PDE, PME/Pi, PDE/ATP, and PDE/Pi were calculated. Influences of liver cirrhosis and ChildPugh stage on skeletal muscle were analyzed. Results31PMRS showed an increase of PME, PCr, βATP, PME/PDE, and Pcr/PDE in liver cirrhosis patients when compared with the controls, whereas the PDE/ATP was the reverse(P<0.05).  The musculoskeletal pHi in ChildPugh stage A, B and C was 7.18±0.10, 7.20±0.10, and 7.41±0.08, respectively, and in PME/PDE was 0.57±0.26, 0.68±0.24, and 1.16±0.24 respectively, which were statistically different (P<0.05). No differences in others parameters were found (P>0.05). Conclusion31PMRS may be used to noninvasively evaluate abnormal musculoskeletal metabolism caused by liver cirrhosis, and the musculoskeletal pHi and PME/PDE increase with the ChildPugh stage.

Key words: Liver cirrhosis; Skeletal muscle; Magnetic resonance spectrum