| 张晓琦,赵明峰,尹建忠,沈文,倪红艳.输血依赖性疾病多脏器铁沉积MRI量化分析[J].中国医学影像技术,2016,32(3):407~410 |
| 输血依赖性疾病多脏器铁沉积MRI量化分析 |
| Quantitative MRI analysis of iron overload in multiple organs in blood-transfusion-dependent disease |
| 投稿时间：2015-06-22 修订日期：2015-12-23 |
| DOI：10.13929/j.1003-3289.2016.03.022 |
| 中文关键词: 磁共振成像 铁沉积 肝脏 胰腺 心脏 |
| 英文关键词:Magnetic resonance imaging Iron overload Liver Pancreas Myocardium |
| 基金项目:天津市卫生行业重点攻关课题(15KG134)。 |
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| 中文摘要: |
| 目的 探讨MRI T2*Map评价输血依赖性疾病患者多脏器铁沉积的价值。方法 收集输血依赖性疾病患者30例,按输血量分为未输血组(n=7)、少量输血组(3年内累计输血量1~150 U,n=13)和大量输血组(3年内输血量>150 U,n=10);收集同期健康志愿者28名(正常组)。采用3.0T MR多回波梯度回波序列获得肝脏、心脏、胰腺的T2* Map,比较组间同器官T2*值,分析不同器官T2*值的相关性及T2*值与血清铁蛋白(SF)、输血量的相关性。结果 正常组和未输血组肝脏T2*值高于少量输血组(q=13.23、12.29)与大量输血组(q=13.10、12.23);正常组和未输血组胰腺T2*值高于少量输血组(q=4.23、3.63)与大量输血组(q=7.14、5.88),少量输血组高于大量输血组(q=2.54);正常组、未输血组心脏T2*值高于大量输血组(q=2.29、3.11);差异均有统计学意义(P均<0.05)。心脏与胰腺T2*值呈正相关(r=0.542,P=0.017),心脏、胰腺与肝脏T2*值均无明显相关性(r=0.32、0.65,P>0.05)。肝脏T2*值与SF呈中度负相关(r=-0.503,P=0.028),心脏、胰腺T2*值与SF无明显相关性(r=-0.30、-0.61,P>0.05);肝脏、胰腺T2*值与3年内输血量呈中度负相关(r=-0.528、-0.793,P均<0.01),心脏T2*值与3年内输血量无明显相关性(r=-0.252,P=0.246)。结论 输血依赖性疾病患者铁最早沉积于肝脏,胰腺、心肌次之;MRI T2* Map可直接、可靠地检测各器官的铁沉积水平。 |
| 英文摘要: |
| Objective To evaluate the features and value of iron deposition in multiple organs of transfusion-dependent-patients using MRI T2* Map. Methods Thirty transfusion-dependent-patients were included and divided into three groups:non transfusion group(total 7 cases), small amount of blood transfusion group(received about 1-150 units blood in 3 years, total 13 cases), and patients with massive blood transfusion group(received more than 150 units blood in 3 years, total 10 cases). 28 healthy volunteers(normal group) were also included. T2* maps of liver, heart and pancreas were acquired using multi-echo gradient echo sequence of 3.0T MRI. The mean T2* value of organs were measured and analyzed with different groups. Pearson correlation was performed to calculate the relationships among T2* values of the different organs in four groups and the relationship between T2* value and serum ferritin(SF), T2* value and transfusion volume. Results The liver T2* values in the normal group and the non transfusion group were higher than that of small amount of blood transfusion group(q=13.23, 12.29) and massive blood transfusion group(q=13.10, 12.23); the pancreas T2* value in the normal group and the non transfusion group were significantly higher than that of small number of blood transfusion group(q=4.23, 3.63) and massive blood transfusion group(q=7.14, 5.88); the value of small amount of blood transfusion group was higher than the massive blood transfusion group(q=2.54); the myocardium T2* value in normal group and non transfusion group were higher than those of the massive blood transfusion group(q=2.29, 3.11); the differences were statistical significance(all P<0.05). Heart T2* value had positive correlation with pancreas T2* value(r=0.542, P=0.017), heart and pancreas T2* value had no correlation with liver T2* value(r=0.32,0.65, P>0.05). Liver T2* had negative correlation with SF(r=-0.503, P=0.028). Heart and T2* value had no correlation with SF(r=-0.30,-0.61, P>0.05). Leart and pancreas T2* value had negative correlation with transfusion volume(r=-0.528,-0.793, P<0.01), Heart T2* value had no correlation with transfusion volume(r=-0.252, P=0.246). Conclusion For long-term transfusion patients, iron deposition occur earliest on liver, and then on the pancreas and myocardium. MRI T2* Map can detect iron deposit level of different organs directly and reliable. |
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