磁共振成像在阿德福韦酯致Fanconi综合征诊断和治疗中的价值  

The diagnosis and therapeutic value of MRI in adefovir dipivoxil-induced Fanconi syndrome

作　　者：练春义[1] 陈旭高[2] 刘江涛[3] 

机构地区：[1]浙江省丽水市中医院放射科,浙江丽水323000 [2]浙江省丽水市人民医院放射科,浙江丽水323000 [3]宁波市第二医院骨科中心,浙江宁波315010

出　　处：《中国现代医生》2016年第3期103-106,109,共5页China Modern Doctor

基　　金：浙江省宁波市科技局自然基金项目(2014A610244)

摘　　要：目的探讨磁共振成像在阿德福韦酯致Fanconi综合征的诊断和疗效评价中的作用,以提高对该病的诊断和治疗水平。方法回顾性分析浙江省丽水市人民医院肾内科自2002年1月～2014年12月期间治疗的3例阿德福韦酯致Fanconi综合征的磁共振资料,所有病例均作常规MR T2WI脂肪抑制序列。所有病例给予纠正酸中毒、补磷、补活性维生素D等治疗。两年内每5个月复查一次,观察磁共振成像信号的变化。结果在膝关节、肩关节、髋关节、脊柱等处,MR T2WI脂肪抑制信号显著增高。通过纠正酸中毒、补磷、补活性维生素D等治疗,高信号明显减低或消失。诊断低磷性骨软化的敏感度达100%。结论 MRI表现结合临床资料对正确诊断和治疗阿德福韦酯致Fanconi综合征有重要价值。Objective To assess the value of MRI in the diagnosis and therapeutic effect evaluation of adefovir dipivoxil-induced Fanconi syndrome,and to improve the diagnosis and treatment of this disease. Methods The MRI findings of 3 cases with adefovir dipivoxil-induced Fanconi syndrome were cured in the urology department of the People′ s Hospital of Lishui City in Zhejiang Province from January 2002 to December 2014 were retrospectively studied, and 11 of the patients also were received examination by T2 WI with fat suppression.11 of the patients also were received the treatment of correction of acidosis, phosphate supplementation and active vitamin D etc. The change of MRI signal was assessed every 5 months in the two years. Results The signal of MRI T2 WI with fat suppression was increased significantly in Knee,shoulder,hip and spine etc. The signal of MRI T2 WI with fat suppression was reduced significantly or disappeared by the treatment of correction of acidosis,phosphate supplementation and active vitamin D etc.The sensitivity of MRI for diagnosis of hypophosphatemia osteomalacia was 100%. Conclusion MRI findings combined with clinical materials have important value in making a correct diagnosis and therapeutic of adefovir dipivoxil-induced Fanconi syndrome.

关 键 词：阿德福韦酯 低磷血症 FANCONI综合征 磁共振成像 线粒体损伤 

分 类 号：R593.23[医药卫生—内科学] R445.2[医药卫生—临床医学]