输血依赖性疾病多脏器铁沉积MRI量化分析  

Quantitative MRI analysis of iron overload in multiple organs in blood-transfusion-dependent disease

作　　者：张晓琦[1,2] 赵明峰[3] 尹建忠[2,4] 沈文[2,4] 倪红艳[2,4] 

机构地区：[1]天津医科大学一中心临床学院,天津300192 [2]天津市第一中心医院放射科,天津300192 [3]天津市第一中心医院血液科,天津300192 [4]天津市影像医学研究所,天津300192

出　　处：《中国医学影像技术》2016年第3期407-410,共4页Chinese Journal of Medical Imaging Technology

基　　金：天津市卫生行业重点攻关课题(15KG134)

摘　　要：目的探讨MRI T2^＊Map评价输血依赖性疾病患者多脏器铁沉积的价值。方法收集输血依赖性疾病患者30例,按输血量分为未输血组（n=7）、少量输血组（3年内累计输血量1-150U,n=13）和大量输血组（3年内输血量〉150U,n=10）;收集同期健康志愿者28名（正常组）。采用3.0T MR多回波梯度回波序列获得肝脏、心脏、胰腺的T2^＊Map,比较组间同器官T2^＊值,分析不同器官T2^＊值的相关性及T2^＊值与血清铁蛋白（SF）、输血量的相关性。结果正常组和未输血组肝脏T2^＊值高于少量输血组（q=13.23、12.29）与大量输血组（q=13.10、12.23）;正常组和未输血组胰腺T2^＊值高于少量输血组（q=4.23、3.63）与大量输血组（q=7.14、5.88）,少量输血组高于大量输血组（q=2.54）;正常组、未输血组心脏T2^＊值高于大量输血组（q=2.29、3.11）;差异均有统计学意义（P均〈0.05）。心脏与胰腺T2^＊值呈正相关（r=0.542,P=0.017）,心脏、胰腺与肝脏T2^＊值均无明显相关性（r=0.32、0.65,P〉0.05）。肝脏T2^＊值与SF呈中度负相关（r=-0.503,P=0.028）,心脏、胰腺T2^＊值与SF无明显相关性（r=-0.30、-0.61,P〉0.05）;肝脏、胰腺T2^＊值与3年内输血量呈中度负相关（r=-0.528、-0.793,P均〈0.01）,心脏T2^＊值与3年内输血量无明显相关性（r=-0.252,P=0.246）。结论输血依赖性疾病患者铁最早沉积于肝脏,胰腺、心肌次之;MRI T2^＊Map可直接、可靠地检测各器官的铁沉积水平。Objective To evaluate the features and value of iron deposition in multiple organs of transfusion-dependentpatients using MRI T2^＊Map.Methods Thirty transfusion-dependent-patients were included and divided into three groups：non transfusion group（total 7cases）,small amount of blood transfusion group（received about 1—150units blood in 3years,total 13cases）,and patients with massive blood transfusion group（received more than 150 units blood in 3years,total 10cases）.28 healthy volunteers（normal group）were also included.T2^＊maps of liver,heart and pancreas were acquired using multi-echo gradient echo sequence of 3.0T MRI.The mean T2^＊value of organs were measured and analyzed with different groups.Pearsoncorrelation was performed to calculate the relationships among T2^＊values of the different organs in four groups and the relationship between T2^＊value and serum ferritin（SF）,T2^＊value and transfusion volume.Results The liver T2^＊values in the normal group and the non transfusion group were higher than that of small amount of blood transfusion group（q=13.23,12.29）and massive blood transfusion group（q=13.10,12.23）;the pancreas T2^＊value in the normal group and the non transfusion group were significantly higher than that of small number of blood transfusion group（q=4.23,3.63）and massive blood transfusion group（q=7.14,5.88）;the value of small amount of blood transfusion group was higher than the massive blood transfusion group（q=2.54）;the myocardium T2^＊value in normal group and non transfusion group were higher than those of the massive blood transfusion group（q=2.29,3.11）;the differences were statistical significance（all P〈0.05）.Heart T2^＊value had positive correlation with pancreas T2^＊value（r=0.542,P=0.017）,heart and pancreas T2^＊value had no correlation with liver T2^＊value（r=0.32,0.65,P〉0.05）.Liver T2^＊had negative correlation with SF（r=-0.503,P=0.028）.Heart and T2^＊value had no correlation with SF（r=-0.30,-0.61,P�

关 键 词：磁共振成像 铁沉积 肝脏 胰腺 心脏 

分 类 号：R589.9[医药卫生—内分泌] R445.2[医药卫生—内科学]