应用磁共振IDEAL-IQ技术评估肝脏铁沉积  

Assessment of Liver Iron Deposition Using MRI IDEAL-IQ Sequence

作　　者：许桂晓 何浩强[2] 彭康强[2] 刘辉明[2] 罗艳亭 罗洁 XU Guixiao;HE Haoqiang;PENG Kangqiang(School of Biomediacal Engineering,Sun Yat-Sen University,Guangzhou 510006,P.R.China)

机构地区：[1]中山大学生物医学工程学院,广州510006 [2]中山大学肿瘤防治中心,华南肿瘤学国家重点实验室,肿瘤医学协同创新中心,广州510006

出　　处：《临床放射学杂志》2019年第11期2200-2204,共5页Journal of Clinical Radiology

摘　　要：目的探讨磁共振最小二乘法估计和不对称回波迭代分解水和脂肪成像(IDEAL-IQ)序列在评估肝脏铁沉积方面的应用价值。方法搜集70例已经病理证实为肝癌、肝癌术后或肝癌微创术后的患者,其中血清铁蛋白正常的有34例,异常的有36例,同期对患者行磁共振IDEAL-IQ序列扫描测量R2*值、行检查序列T2WI测量肝脏/肌肉信号强度对比噪声比(CNR)。通过测量R2*值和肝脏/肌肉CNR值评估肝铁含量并研究其和血清铁蛋白的相关性;采用受试者工作特征曲线(ROC)分析比较R2*值和CNR值两种方法评估肝铁沉积准确性,以ROC曲线下面积(AUC)评价。结果 IDEAL-IQ序列测得血清铁蛋白正常组R2*值为(49.94±1.23)Hz,血清铁蛋白异常组为(87.52±5.57)Hz,两者间有统计学差异((P<0.05);正常组肝脏/肌肉CNR值为0.97±0.78,异常组肝脏/肌肉CNR值为-1.79±0.45,两者间有统计学差异(P<0.05)。正常组的R2*值与其血清铁蛋白呈中度正相关性(r=0.64,P<0.05),异常组的R2*值与其血清铁蛋白呈中度正相关性(r=0.69,P<0.05);正常组的肝脏/肌肉CNR值与血清铁蛋白无统计学相关性,异常组的肝脏/肌肉CNR值与血清铁蛋白呈轻度负相关性(r=-0.48,P<0.05)。R2*值评估肝铁沉积精确性的AUC值为0.94,肝脏/肌肉CNR值评估法的AUC值为0.69。结论磁共振IDEAL-IQ技术测量R2*值可简单、快捷、无创评估肝脏铁沉积,并定量测量肝脏铁沉积程度,相对于测量肝脏/肌肉CNR值评估肝脏铁沉积更为准确。Objective To study the applicability of MRI IDEAL-IQ sequence imaging technique in the evaluation of liver iron deposition. Methods 70 patients with diagnosis of liver cancer,or after operation or minimally invasive surgery were selected. There were 34 cases with normal serum ferritin and 36 abnormal cases.R2* value was measured by IDEAL-IQ,and the liver/muscle CNR(contrast to noise ratio,CNR) valuue was measured using sequence T2 WI at the same time.The concentration of iron in the liver was estimated by both R2* and CNR,and the correlations between the concentration of serum ferritin and R2* as well as CNR were both calculated.We utilized area under the receiver operating characteristic curve(ROC-AUC)to analyze and compare the accuracy of the two methods(R2* obtained from IDEAL-IQ and CNR obtained from T2WI). Results The value of R2* measured by IDEAL-IQ in normal serum ferritin group was 49.94 ±1.23(Hz),and that in the abnormal group was 87.52±5.57(Hz).There was a significant difference between the two groups(P< 0.05).The CNR value of the normal group was 0.97±0.78,while that in the abnormal group was-1.79±0.45.There was a significant difference between the two groups(P<0.05).There was a moderate positive correlation between the value of R2* and the concentration of serum ferritin in the normal group(r=0.64,P<0.05)as well as in the abnormal group(r=0.69,P<0.05).There was no significant correlation between CNR and the concentration of serum ferritin in the normal group,while there was a slight negative correlation in the abnormal group(r=-0.48,P<0.05). The AUC value of ROC for evaluating the accuracy of liver iron deposition by the R2* value was 0.94 and that by CNR value was 0.69. Conclusion R2* measured by MRI IDEAL-IQ imaging technique is potentially a simple,rapid and noninvasive tool to evaluate liver iron deposition,and it could be used to quantitatively assess the degree of liver iron deposition.Compared to CNR,R2* is more accurate in evaluating liver iron deposition.

关 键 词：肝 磁共振成像 铁 

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