CAJ | 학술논문

目的研究磁共振成像(MRI)技术定量检测铁过载的情况并与传统方法进行比较.方法选取2010年12月至2012年12月北京4家医院临床上怀疑有铁过载而在北京协和医院进行MRI定量检测的患者53例,应用MRI T2* mapping的方法测定患者肝脏及心脏T2*值,依照MRI T2*值判断铁过载情况并与同期检测的血清铁蛋白(SF)、输血量及其他临床表现及实验室指标进行比较分析.结果本组男37例,女16例,中位年龄50岁(15 ～ 72岁),其中,骨髓增生异常综合征(MDS)25例,再生障碍性贫血(AA)16例,骨髓纤维化5例,血色病2例,β地中海贫血携带者2例,体检发现SF升高3例.45例患者有输血史;SF＞ 1000 μg/L者49例;有铁过载相关体征者10例;肝功能异常38例,血糖升高者32例.经MRI定量检测,10例无肝脏及心脏铁过载;43例出现肝脏铁过载,其中14例为轻度铁过载,22例为中度铁过载,7例为重度铁过载.43例肝脏铁过载患者中2例合并心脏铁过载,分别为MDS和慢性AA患者,有大量输血史,其中l例合并心力衰竭表现.肝脏T2*值与SF、输血量之间均无相关性(P=0.050、0.820);肝脏T2*值和心脏T2*值之间也无相关性(P =0.129).结论 MRI定量检测脏器铁过载的方法是现有血清测定铁含量的有益补充,与目前评估铁过载的手段相结合,可以更全面地了解患者铁过载的程度.
목적 연구자공진성상(MRI)기술정량검측철과재적정황병여전통방법진행비교.방법 선취2010년12월지2012년12월북경4가의원림상상부의유철과재이재북경협화의원진행MRI정량검측적환자53례,응용MRI T2* mapping적방법측정환자간장급심장T2*치,의조MRI T2*치판단철과재정황병여동기검측적혈청철단백(SF)、수혈량급기타림상표현급실험실지표진행비교분석.결과 본조남37례,녀16례,중위년령50세(15 ～ 72세),기중,골수증생이상종합정(MDS)25례,재생장애성빈혈(AA)16례,골수섬유화5례,혈색병2례,β지중해빈혈휴대자2례,체검발현SF승고3례.45례환자유수혈사;SF＞ 1000 μg/L자49례;유철과재상관체정자10례;간공능이상38례,혈당승고자32례.경MRI정량검측,10례무간장급심장철과재;43례출현간장철과재,기중14례위경도철과재,22례위중도철과재,7례위중도철과재.43례간장철과재환자중2례합병심장철과재,분별위MDS화만성AA환자,유대량수혈사,기중l례합병심력쇠갈표현.간장T2*치여SF、수혈량지간균무상관성(P=0.050、0.820);간장T2*치화심장T2*치지간야무상관성(P =0.129).결론 MRI정량검측장기철과재적방법시현유혈청측정철함량적유익보충,여목전평고철과재적수단상결합,가이경전면지료해환자철과재적정도.
Objective To evaluate the significance of magnetic resonance imaging (MRI) T2* value analysis in patients with iron overload and compare it with other clinical parameters.Methods A total of 53 patients with suspected iron overload were recruited from four Beijing hospitals from December 2010 to December 2012.Their liver and heart T2 * values were calculated and their serum ferritin (SF),transferin saturation,blood transfusion volume and other clinical parameters were recorded and analyzed.Results There were 37 males and 16 females with a medium age of 50 years(15-72 years).Their etiologies included myelodysplastic syndromes (MDS,n =25),aplastic anemia (AA,n =16),myelofibrosis (n =5),hemachromatosis (n =2) and β thalassaemia (n =2),and 3 patients with high SF values were found on regular health examinations.Among them,there were transfusion history (n =45),SF ＞ 1000 μg/L (n =49),sign of iron overload (n =10),abnormal liver function (n =38) and hyperglycemia (n =32).T2* value analysis showed that 10 patients had no evidence of iron overload,43 patients had liver iron overload (14 mild,22 moderate and 7 severe) and 2 patients had heart iron overload (1 MDS with heavy transfusion history and 1 AA with heart failure).No relations existed between T2 * value and SF (P =0.050),T2 * value and transfusion volume (P =0.820),and liver T2 * value and heart T2 * value (P =0.129).Conclusions MRI T2* value is an accurate way of quantitative detection of iron overload.It provides a comprehensive understanding of patients with iron overload in conjunctions with MRI T2 * value and other clinical parameters.