| 沈君,洪国斌,成丽娜,段小慧,钟小梅,梁碧玲,徐宏贵,陈纯.骨髓MRI在重型β-地中海贫血造血干细胞移植中的价值[J].中国医学影像技术,2008,24(5):738~742 |
| 骨髓MRI在重型β-地中海贫血造血干细胞移植中的价值 |
| Clinical relevance of bone marrow MR imaging in hematopoietic stem cell transplantation of β-thalassemia |
| 投稿时间：2007-12-13 修订日期：2008-03-04 |
| DOI： |
| 中文关键词: 造血干细胞移植 β-地中海贫血 磁共振成像 |
| 英文关键词:Hematopoietic stem cell transplantation Bata-thalassemia Magnetic resonance imaging |
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| 中文摘要: |
| 目的 探讨骨髓MRI在重型β地中海贫血造血干细胞移植(HSCT)中的价值。方法 对27例拟行HSCT重型地中海贫血患儿的股骨骨髓进行MRI检查。进行FSE的T1WI及T2WI、STIR、同相位及反相位快速场回波序列(FFE)股骨近段斜冠状位成像。在T1WI、T2WI及STIR图像上判断红黄骨髓的分布,并测量股骨近段红骨髓总面积及其百分比。在同相位、反相位FFE图像上序列判断骨髓是否有铁沉积。比较不同病情及不同移植结局患者的红骨髓面积及其百分比及骨髓内铁沉积,并与临床实验室指标进行相关性分析。运用Logistic回归分析红骨髓面积及其百分比、骨髓铁沉积与HSCT结局之间的关系。结果 27例重型地中海贫血中,10例出现骨髓铁沉积,骨髓铁沉积与临床指标无相关性(P>0.05),对HSCT结局无影响(P＝0.775)。红骨髓面积及其百分比与病程及血清铁蛋白正相关(r=0.727、0.428,P<0.05;r=0.487、0.511,P＝0.01、0.006)。27例中2例死于预处理,余25例进行了HSCT。进行HSCT的25例中,移植成功及移植失败病例中红骨髓面积及其百分比分别为(7.94±2.71) mm2(90.25%±4.14%),(10.54±3.31) mm2(94.54%±2.93%),两组之间均有统计学差异(P＝0.04、0.01)。回归分析显示红骨髓面积百分比与HSCT结局密切相关(OR=1.383,P＝0.005)。结论 MRI上股骨近段红骨髓面积百分比可作为重型地中海贫血HSCT病情分类的一个独立危险因素。 |
| 英文摘要: |
| Objective The clinical relevance of femoral marrow MR imaging in hematopoietic stem cell transplantation (HSCT) in β-thalassemia major is unknown. This study aims to investigate the value of femoral marrow MR imaging as an alternative risk factor for HSCT in thalassemia major. Methods MRI of the proximal femur was undertaken in 27 β-thalassemia major patients being prepared for HSCT. Using oblique coronal T1-, T2-weighted spin echo and short-tau inversion recovery images, the area of red marrow and its percentage in the proximal femur were measured. Using in-phase, out-of-phase fast field echo (FFE) images, the degree of proximal femoral marrow hemosiderosis was assessed. Following MRI, HSCT was undertaken in 25 of 27 patients. Red marrow area and degree of marrow hemosiderosis were compared amongst patients with different disease conditions and different transplant outcomes and correlated with clinical features. Logistic regression analyses were used to determine the influence of red marrow area and marrow hemosiderosis on transplant outcome. Results Marrow hemosidersosis was found in 10 of 27 patients. The marrow hemosiderosis was not correlated with any clinical features (P>0.05) and did not influence the outcome of HSCT (P＝0.775). Red marrow area and its percentage correlated positively with the course time of disease (r=0.727, 0.428, P<0.05) and serum ferritin (r=0.487, 0.511, P＝0.01, 0.006). Red marrow area and its percentage was less in patients with successful ( mm2, 90.25%±4.14%) than unsuccessful transplants ( mm2 , 94.54%±2.93%)(P＝0.04, 0.01). Regression analyses showed that red marrow area percentage was an independent risk factor for successful HSCT (odds ratio of 1.383, P＝0.005). Conclusion Red marrow area percentage of proximal femur on MRI is an independent risk factor for successful HSCT. |
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