Ronald Ouwerkerk PhD, Presenter: Nothing to Disclose

Yaron Rotman MD, Abstract Co-Author: Nothing to Disclose

Ranganath Muniyappa MD, Abstract Co-Author: Nothing to Disclose

Christopher E. Ramsden MD, Abstract Co-Author: Nothing to Disclose

Monica C. Skarulis MD, Abstract Co-Author: Nothing to Disclose

Ahmed Medhat Gharib MBChB, Abstract Co-Author: Nothing to Disclose

To test the hypothesis that low choline is linked with hepatosteatosis in humans. Choline deficient diets can be used to create animal models of non-alcoholic hepatosteatosis (NASH). Choline is an essential factor in creating very low-density lipoproteins (VLDL) and this is the main vehicle for clearing lipids from the liver. It is therefore conceivable that at least in some humans with elevated liver fat content the cause is also linked to an abnormal choline supply in the liver.

Thirteen healthy controls and ten patients with NASH were recruited for studies to measure liver fat with MRS. All were scanned in a 3T MR scanner with a comprehensive liver exam including localized MRS. Both T1 weighted expiration breath-hold and T2 weighted navigator gated scouts were scanned in transverse and coronal orientations. Single volume localized MR spectra were acquired in the liver in single breath-hold and with navigator gating. Volumes (8ml) were carefully placed in the right posterior lobe of the liver, avoiding blood vessels and fatty structures. Single breath-hold scans were used to collect spectra with a series of TE to determine the T2 of water and fat. Navigator-gated MRS was used for measurement of the fat fraction ff=fat/(fat+water), and choline content, both corrected for T2 relaxation of water and fat.

The liver ff in the controls was predictably lower than in NASH patients :0.90 ± 0.63, in controls (N=13) vs. 9.9 ± 3.7 in NASH (N=10). The liver choline content was higher in controls (5.7±1.3, range 4.5-8.2 mmol/kg ww, N=13) than in NASH (2.6 ± 1.6 range 0.3-5.6 mmol/kg ww, N=10). The difference was significant with p < 0.0001 in an unpaired heteroscedactic t-test. A figure with choline as a function of ff shows the difference in both ff and choline content between controls (black squares) and NASH (open circles). There was no strong linear correlation between choline and ff (shown for NASH only).

There is a clear reduction in choline-containing compounds detectable by MRS in most subjects with NASH. Even though the individual causes of NASH may vary, the data support the hypothesis that there is a link between liver choline content and elevated haptic lipid content.

Relating liver choline content with liver fat content could reveal information about the cause of the fat accumulation in the liver in NASH.

Ouwerkerk, R, Rotman, Y, Muniyappa, R, Ramsden, C, Skarulis, M, Gharib, A, Low Liver Choline Content in Non Alcoholic Hepatosteatosis Measured with Localized 1H-MRS.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013657.html