Concentration of Gallbladder Phosphatidylcholine in Cholangiopathies: A Phosphorus‐31 Magnetic Resonance Spectroscopy Pilot Study

• Published in: Journal of magnetic resonance imaging Vol. 55; no. 2; pp. 530 - 540
• Main Authors: Pfleger, Lorenz, Halilbasic, Emina, Gajdošík, Martin, Benčíková, Diana, Chmelík, Marek, Scherer, Thomas, Trattnig, Siegfried, Krebs, Michael, Trauner, Michael, Krššák, Martin
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.02.2022; Wiley Subscription Services, Inc
• Subjects: Adenosine triphosphate; Adult; Age; ATP; Bile ducts; Biomarkers; cholangiopathy; Cholangitis; Cholangitis, Sclerosing; Female; Field strength; Gallbladder; Humans; Image acquisition; In vivo methods and tests; Lecithin; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Metabolites; Middle Aged; Pathogenesis; Phosphatidylcholine; Phosphatidylcholines; Phosphorus; Pilot Projects; Relaxation time; Resonance; Spectral resolution; Spectroscopy; Spectrum analysis; Statistical analysis; Statistical tests; Subgroups; T1 relaxation; cholangiopathy; magnetic resonance spectroscopy; gallbladder; phosphatidylcholine; T1 relaxation; phosphorus
• ISSN: 1053-1807; 1522-2586; 1522-2586
• DOI: 10.1002/jmri.27817

Background Biliary phosphatidylcholine (PtdC) concentration plays a role in the pathogenesis of bile duct diseases. In vivo phosphorus‐31 magnetic resonance spectroscopy (31P‐MRS) at 7 T offers the possibility to assess this concentration noninvasively with high spectral resolution and signal intensity. Purpose Comparison of PtdC levels of cholangiopathic patient groups to a control group using a measured T1 relaxation time of PtdC in healthy subjects. Study Type Case control. Subjects Two patient groups with primary sclerosing cholangitis (PSC, 2f/3 m; age: 43 ± 7 years) and primary biliary cholangitis (PBC, 4f/2 m; age: 57 ± 6 years), and a healthy control group (CON, 2f/3 m; age: 38 ± 7 years). Ten healthy subjects for the assessment of the T1 relaxation time of PtdC. Field Strength/Sequence A 3D phase‐encoded pulse‐acquire 31P‐MRSI sequence for PtdC quantification and a 1D image‐selected in vivo 31P spectroscopy for T1 estimation at 7 T, and a T2‐weighted half‐Fourier single‐shot turbo spin echo MRI sequence for volumetry at 3 T. Assessment Calculation of gallbladder volumes and PtdC concentration in groups using hepatic gamma‐adenosine triphosphate signal as an internal reference and correction for insufficient relaxation of PtdC with a T1 value assessed in healthy subjects. Statistical Tests Group comparison of PtdC content and gallbladder volumes of the PSC/PBC and CON group using Student's t‐tests with a significance level of 5%. Results PtdC T1 value of 357 ± 85 msec in the gallbladder. Significant lower PtdC content for the PSC group, and for the female subgroup of the PBC group compared to the CON group (PSC/CON: 5.74 ± 0.73 mM vs. 9.64 ± 0.97 mM, PBC(f)/CON: 5.77 ± 1.44 mM vs. 9.64 ± 0.97 mM). Significant higher gallbladder volumes of the patient groups compared to the CON group (PSC/CON: 66.3 ± 15.8 mL vs. 20.9 ± 2.2 mL, PBC/CON: 49.8 ± 18.2 mL vs. 20.9 ± 2.2 mL). Data Conclusion This study demonstrated the application of a 31P‐MRSI protocol for the quantification of PtdC in the human gallbladder at 7 T. Observed differences in PtdC concentration suggest that this metabolite could serve as a biomarker for specific hepatobiliary disorders. Level of Evidence 2 Technical Efficacy Stage 3