A novel approach for the diagnosis of human hepatopancreatobiliary diseases: in vivo magnetic resonance spectroscopy of bile in one and two dimensions

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dc.contributor.supervisor Smith, Ian C.P. (Human Anatomy and Cell Sciences) en_US
dc.contributor.author Mohajeri, Sanaz
dc.date.accessioned 2014-04-11T17:29:05Z
dc.date.available 2014-04-11T17:29:05Z
dc.date.issued 2014-04-11
dc.identifier.uri http://hdl.handle.net/1993/23446
dc.description.abstract Bile is a biofluid synthesized by liver and concentrated in the gallbladder. Interference with the bile flow may cause cholestasis. Primary sclerosing cholangitis (PSC) is an inflammatory cholestatic disorder which eventually may result in liver cirrhosis and failure. The management of PSC is controversial. The only effective treatment for end stage disease is orthotopic liver transplantation (OLT). However, cholangiocarcinoma (CC), which is the major complication of this long-lasting disease, is an absolute contraindication for the surgery. Therefore, early diagnosis of the disease can not only improve the outcome of PSC, but also facilitate the allocation of donated livers to those who can benefit from transplantation. Unfortunately, the diagnosis of CC is challenging. Endoscopic retrograde cholangiopancreatography (ERCP), the gold standard technique, is highly invasive. Non-invasive alternatives such as magnetic resonance cholangiopancreatography (MRCP) have lower accuracy. Therefore, it is essential to develop more accurate and less invasive diagnostic techniques. Magnetic resonance spectroscopy (MRS) is an evolving technique with potential to detect disease-related metabolic changes. In vitro studies have proven the capacity of MRS in the early detection of hepatopancreatobiliary (HPB) disorders based on the metabolic analysis of bile obtained invasively. An in vivo alternative has been attempted by others on human bile within the gallbladder. However, due to the poor quality of the acquired spectra, quantification of most major bile metabolites was not possible, except for choline-containing phospholipids (chol-PLs). In the current study, the quality of the in vivo 1D spectra has been greatly improved, and we have obtained the first 2D L-COSY spectra from bile within the gallbladder. Spectral data from healthy controls and PSC patients were compared. Statistically significant differences in the concentrations of chol-PLs, and glycine- and taurine-conjugated bile acids were revealed in the 1D analysis. Our 2D spectra also demonstrated potential for the detection of metabolic differences between the two groups. The success of these studies indicates a strong potential of in vivo bile MRS techniques to characterize and diagnose a wide variety of HPB disorders. en_US
dc.rights info:eu-repo/semantics/openAccess
dc.subject human bile en_US
dc.subject in vivo 1H MRS en_US
dc.subject glycine-conjugated bile acids en_US
dc.subject taurine-conjugated bile acids en_US
dc.subject choline-containing phospholipids en_US
dc.subject PRESS en_US
dc.subject L-COSY en_US
dc.title A novel approach for the diagnosis of human hepatopancreatobiliary diseases: in vivo magnetic resonance spectroscopy of bile in one and two dimensions en_US
dc.type info:eu-repo/semantics/doctoralThesis
dc.degree.discipline Human Anatomy and Cell Science en_US
dc.contributor.examiningcommittee Anderson, Judy (Biological Sciences) Klonisch, Thomas (Human Anatomy and Cell Sciences) Bezabeh, Tedros (Human Nutritional Sciences) MacKay, Alex (University of British Columbia) en_US
dc.degree.level Doctor of Philosophy (Ph.D.) en_US
dc.description.note May 2014 en_US

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