重型β地中海贫血肝脏铁沉积的MRI与病理学相关分析  

MR imaging of liver iron storage in patients with β-thalassaemia major:correlation analysis with pathology

作　　者：钟小梅[1] 沈君[1] 段小慧[1] 成丽娜[1] 徐宏贵[2] 陈纯[2] 梁碧玲[1] 

机构地区：[1]中山大学附属第二医院放射科,广东广州510120 [2]中山大学附属第二医院儿科,广东广州510120

出　　处：《中国医学影像技术》2009年第3期456-458,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的通过与组织病理学对照,探讨MRI评价重型β地中海贫血肝脏铁沉积的价值。方法对35例重型β地中海贫血患者行肝脏、脾脏MR检查并进行肝脏穿刺活检,在TSET2WI上测量肝脏/肌肉、脾脏/肌肉信号强度比,与血清铁蛋白、肝穿刺活检中的肝含铁血黄素细胞百分比之间进行相关性分析。结果35例地中海贫血的肝/肌信号强度为(0.53±0.24),脾/肌信号强度比为(2.47±1.71),血清铁蛋白为(2912.77±1646.01)μg/L,肝脏含铁血黄素细胞百分比为(61.57%±18.26%,中位数60.00%)。肝/肌信号强度比与血清铁蛋白、肝含铁血黄素细胞百分比均呈负相关(r=-0.38,-0.44,P均<0.05),脾/肌信号强度比与血清铁蛋白负相关(r=-0.41,P=0.03),但脾/肌信号强度比、血清铁蛋白与含铁血黄素细胞百分比均无相关性。结论MRI测量肝脏信号强度比可作为无创伤性动态评估肝脏铁负荷的一个补充方法。Objective To investigate the value of MR] in the evaluation of liver iron storage by correlation with histopathology. Methods Abdominal MR image and liver biopsy were performed in 35 patients with β-thalassaemia major. The signal intensity ratios of liver and spleen to the paraspinous muscles （L/M-SIR, S/M-SIR, respectively） were measured on TSE T2WI. The correlation between L/M-SIR, S/M-SIR, serum ferritin and the percentage of hemosiderntic cells in liver deter mined by biopsy were analyzed. Results L/M-SIR, S/M SIR, serum ferritin and the percentage of hemosiderotic cells in liver of 35 cases of β-thalassaemia major were （0.53±0.24）, （2.47±1.71）, （2912.77±1646.01）μg/L and （61.57±18.26%, median 60.00%） respectively. I./M-SIR was negatively correlated with serum ferritin and the percentage of hemo- siderotic cells （r=-0. 38, P=0.02 and r=-0.44, P=0.01, respectively）. A negative correlation was found between S/M-SIR and serum ferritin （r=-0.41. P=0.03）, but there was no correlation between the percentage of hemosiderotic cells and S/M-SIR and serum ferritin. Conclusion Measurement of signal intensity ratio of liver on MR imaging can be used as a complementary and non-invasive approach to dynamically assess liver iron overload in β-thalassaemia major.

关 键 词：重型Β地中海贫血 铁负荷 铁蛋白 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.5[医药卫生—诊断学]