In vivo and in vitro hepatic 31P magnetic resonance spectroscopy and electron microscopy of the cirrhotic liver.
In vivo and in vitro hepatic 31P magnetic resonance spectroscopy and electron microscopy of the cirrhotic liver.
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DOI：
10.1111/j.1600-0676.1997.tb00806.x
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发表时间：
2008-12
期刊：
影响因子：
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通讯作者：
S. Taylor-Robinson;J. Sargentoni;Jimmy D Bell;N. Saeed;K. Changani;B. Davidson;K. Rolles;A. Burroughs;H. Hodgson;C. Foster;I. Cox
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文献类型：
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作者：
S. Taylor-Robinson;J. Sargentoni;Jimmy D Bell;N. Saeed;K. Changani;B. Davidson;K. Rolles;A. Burroughs;H. Hodgson;C. Foster;I. Cox
在体内31 P磁共振波谱（MRS）提供了肝脏代谢过程的直接生化信息。为了评估肝移植候选者肝脏31 P MRS的体内变化，我们研究了31例不同病因的肝硬化患者; 14例代偿性肝硬化（Pugh评分≥ 8）。使用体外31 P MRS和电子显微镜表征潜在的细胞异常。从所有受试者的肝提取物中获得体外光谱，在受体肝切除术时冷冻夹紧。17例同时行肝组织电镜检查。相对于核苷酸三磷酸，在体内观察到磷酸单酯升高和磷酸二酯减少，肝功能恶化。体外光谱显示磷酸乙醇胺和磷酸胆碱升高，甘油磷酸乙醇胺和甘油磷酸胆碱降低，反映了体内的变化，但代偿性和失代偿性肝硬化之间没有区别。通过电子显微镜观察，功能性失代偿与实质性肝病中内质网减少有关，但与胆汁性肝硬化中内质网水平升高有关。我们的结论是肝硬化的体内光谱异常与磷脂代谢和内质网数量的改变是一致的。然而，在个体患者中，活检结果并不总是反映体内结果。
In vivo 31P magnetic resonance spectroscopy (MRS) provides direct biochemical information on hepatic metabolic processes. To assess in vivo changes in hepatic 31P MRS in liver transplant candidates, we studied 31 patients with cirrhosis of varying aetiology; 14 with compensated cirrhosis (Pugh's score or = 8). Underlying cellular abnormalities were characterised using in vitro 31P MRS and electron microscopy. In vitro spectra were obtained from liver extracts, freeze-clamped at recipient hepatectomy, from all subjects. Electron microscopy of liver tissue was also performed in 17 cases. Relative to nucleotide triphosphates, elevations in phosphomonoesters and reductions in phosphodiesters were observed in vivo with worsening liver function. In vitro spectra showed elevated phosphoethanolamine and phosphocholine, and reduced glycerophosphorylethanolamine and glycerophosphorylcholine, mirroring the in vivo changes, but no distinction was noted between compensated and decompensated cirrhosis. With electron microscopy, functional decompensation was associated with reduced endoplasmic reticulum in parenchymal liver disease, but elevated levels in biliary cirrhosis. We conclude that in vivo spectral abnormalities in cirrhosis are consistent with alterations in phospholipid metabolism and quantity of endoplasmic reticulum. However, in individual patients the biopsy results do not always mirror in vivo findings.