| 雷子豪,陶超,徐亮,刁海涛,翟建,俞咏梅.基于定量磁化率成像观察不同活动度系统性红斑狼疮患者脑深部核团铁沉积差异[J].中国医学影像技术,2025,41(4):587~591 |
| 基于定量磁化率成像观察不同活动度系统性红斑狼疮患者脑深部核团铁沉积差异 |
| Observation on difference of iron deposition in deep brain nuclei of systemic lupus erythematosus patients with different disease activity levels using quantitative susceptibility mapping |
| 投稿时间：2024-10-09 修订日期：2025-03-31 |
| DOI：10.13929/j.issn.1003-3289.2025.04.017 |
| 中文关键词: 红斑狼疮,系统性 壳核 铁 磁共振成像 |
| 英文关键词:lupus erythematosus, systemic putamen iron magnetic resonance imaging |
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| 中文摘要: |
| 目的 基于定量磁化率成像(QSM)观察不同活动度系统性红斑狼疮(SLE)患者脑深部核团铁沉积的差异。方法 回顾性纳入54例SLE,根据SLE活动指数(SLEDAI)将其分为中-重度活动组(评分＞9分,n=25)及轻度活动组(评分≤9分,n=29)。比较组间患者基本资料,以及双侧尾状核头、壳核、苍白球、红核、黑质、齿状核及丘脑等深部核团QSM均值;以Pearson或Spearman相关系数分析组间差异有统计学意义核团的QSM均值与常规临床指标的相关性,并以受试者工作特征(ROC)曲线下面积(AUC)评估QSM均值鉴别中-重度与轻度活动SLE的效能。结果 中-重度活动组铁蛋白、红细胞沉降率(ESR)、C反应蛋白(CRP)、抗双链DNA(anti-dsDNA)抗体水平及抗核糖体P蛋白(anti-P)抗体阳性者占比均高于,而补体C3、C4水平均低于轻度活动组(P均＜0.05)。中-重度活动组双侧壳核及丘脑QSM均值高于轻度活动组(P均＜0.05)。SLE患者双侧壳核QSM均值与SLEDAI评分、铁蛋白及anti-P抗体阳性呈正相关(r或rs=0.447、0.526、0.473,P均＜0.05);以双侧壳核QSM的均值鉴别中-重度与轻度活动SLE的AUC为0.810。结论 中-重度与轻度活动SLE患者脑深部核团异常铁沉积存在差异;双侧壳核QSM均值可用于鉴别中-重度与轻度活动SLE。 |
| 英文摘要: |
| Objective To observe the difference of iron deposition in brain deep nuclei of systemic lupus erythematosus (SLE) patients with different disease activity levels using quantitative susceptibility mapping (QSM). Methods Fifty-four SLE patients were retrospectively enrolled and divided into moderate to severe activity group (score＞9, n=25) and mild activity group (score≤9, n=29) according to SLE disease activity index (SLEDAI) score. Patients’ general clinical data, as well as the mean QSM of bilateral head of caudate nuclei, putamina, globi pallidi, red nuclei, substantiae nigrae, dentate nuclei and thalami were compared between groups. Pearson or Spearman coefficients were performed to analyze correlations of the mean QSM of nuclei being significant different between groups and conventional clinical indicators. Then receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated to evaluate the efficacy of the mean QSM for distinguishing moderate to severe and mild activity SLE. Results Compared with mild activity group, moderate to severe activity group had higher serum ferritin, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), anti-double stranded DNA (anti-dsDNA) antibody levels, also higher proportion of positive anti-ribosomal P protein (anti-P) antibodies, but lower complement C3 and C4 levels (all P＜0.05). The mean QSM of bilateral putamina and thalami were significantly higher in moderate to severe activity group than in mild activity group (both P＜0.05). The mean QSM of bilateral putamina was positively correlated with SLEDAI scores, ferritin levels and positivity of anti-P antibodies in SLE patients (with r or rs of 0.447, 0.526 and 0.473, respectively, and all P＜0.05). The AUC for distinguishing moderate to severe SLE and mild activity SLE based on the mean bilateral putamina QSM was 0.810. Conclusion There were significant differences of iron deposition in deep brain nuclei of SLE patients with moderate to severe and mild activity. The mean QSM of bilateral putamina could be used to distinguish SLE with moderate to severe activity and mild activity. |
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