磁共振成像用于血液病患者铁过载评估的初步研究  

MRI for assessment of iron overload in patients with hematologic disease

作　　者：肖超[1] 顾树程[1] 徐燕军[2] 陈卓[1] 宋陆茜[1] 常春康[1] 

机构地区：[1]上海交通大学附属第六人民医院血液科,200233 [2]上海交通大学附属第六人民医院放射科,200233

出　　处：《中华血液学杂志》2015年第12期1039-1042,共4页Chinese Journal of Hematology

摘　　要：目的比较磁共振成像（MRI）肝横向弛豫时间（T2＊）、心T2＊检测和血清铁蛋白（SF）评估铁过载的特征。方法对2011年11月至2014年6月69例患者进行肝脏、心脏MRI检查，并采集其各项临床数据进行分析。结果肝T2＊与调整后铁蛋白（ANF）水平明显相关（P=0．003）。心T2＊与肝T2＊、ASF水平均无明显相关性。69例患者中，62例肝T2＊诊断为铁过载，其中重度铁过载20例（32．26％）；47例ASF诊断为铁过载，其中重度14例（29．79％）；25例心T2＊诊断为铁过载，无一例为重度铁过载。结论SF易受其他因素影响而无法完全客观地反映机体铁沉积水平；肝T2＊检测可信度强、重复性好。心T2＊不能正确评估全身铁过载的情况，仅仅是检测心脏铁沉积的一种手段。Objective Compare the characteristics of magnetic resonance imaging （MR/） liver T2＊, cardiac T2＊ and serum ferritin on the assessment of iron overload. Methods A total of sixty-nine patients from November 2011 to June 2014 were enrolled in this study. Their cardiac and liver iron concentration levels were measured through MRI examination, with other clinical data were collected to perform statistical analysis. Results The correlation between liver T2＊ and adjusted serum ferritin （ASF） was statistically significant （P=0.003）. However, no significant correlation was found between cardiac T2＊ and liver T2＊, ASF, respectively. According to the statistical analysis of the 69 cases, it is found that the number of iron overload cases diagnosed by liver T2＊ was 62 and 20 cases were severe iron overload （32.26%）; the number of iron overload cases diagnosed by ASF was 47 and 14 cases were severe iron overload （29.79%）, while the number of iron overload cases diagnosed by cardiac T2＊ was only 25 and no severe iron overload cases. Conclusion Since SF was affected by other factors, it cannot reflect the level of iron overload in human body objectively. Now, liver T2＊ has become the gold standard for assessment of iron overload because of its good reliability and repeatability. However, cardiac T2＊ cannot correctly be used as assessment for iron overload, and it is only a method of evaluating the level of cardiac iron deposition.

关 键 词：磁共振成像 肝T2＊ 心T2＊ 铁蛋白质类 铁超负荷 

分 类 号：R55[医药卫生—血液循环系统疾病]