31P magnetic resonance spectroscopy detects a functional abnormality in liver metabolism after acetaminophen poisoning

Authors

  • Dr. Ruth M. Dixon,

    Corresponding author
    1. Medical Research Council Biochemical and Clinical Magnetic Resonance Unit, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
    • MRC Biochemical and Clinical Magnetic Resonance Unit, John Radcliffe Hospital, Oxford, OX3 9DU, UK
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  • Peter W. Angus,

    1. Medical Research Council Biochemical and Clinical Magnetic Resonance Unit, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
    Current affiliation:
    1. The Austin Hospital, Studley Road, Heidelberg 3084, Victoria, Australia
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  • Bheeshma Rajagopalan,

    1. Medical Research Council Biochemical and Clinical Magnetic Resonance Unit, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
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  • George K. Radda

    1. Medical Research Council Biochemical and Clinical Magnetic Resonance Unit, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
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Abstract

Eighteen patients with acetaminophen poisoning were studied with 31P magnetic resonance spectroscopy to measure phosphorus-containing metabolites in their livers. The concentrations of all magnetic resonance—detectable metabolites fell in parallel with a decrease in the synthetic ability of the liver, indicated by the prothrombin time ratio (international normalized ratio). In particular, ATP fell to about 20% of its normal concentration in severely affected patients, as did the phosphodiester signal, which is thought to arise mainly from the endoplasmic reticulum in the liver. The correlation between ATP levels and international normalized ratio suggests that the international normalized ratio is a more accurate measure of the number of viable hepatocytes than are other biochemical tests. (HEPATOLOGY 1992;16:943–948.)

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