MRI-T2^(*)技术定量分析β-重型地中海贫血心脏、肝脏、胰腺铁沉积及其与糖代谢的相关性  

MRI-T2^(*)technique in quantitative analysis of myocardium,liver and pancreas iron deposition inβ-thalassemia major and the correlations with glucose metabolism

作　　者：黄静文[1] 程子亮 杨绮华[1] 余太慧[1] 黎继昕 苏赟[1] 梁碧玲[1] HUANG Jingwen;CHENG Ziliang;YANG Qihua;YU Taihui;LI Jixin;SU Yun;LIANG Biling(Department of Radiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院放射科,广东广州510120

出　　处：《中国医学影像技术》2021年第4期557-561,共5页Chinese Journal of Medical Imaging Technology

基　　金：中山大学临床医学研究5010计划(2013004);广东省自然科学基金(2018A0303130099)。

摘　　要：目的采用MRI-T2^(*)技术定量分析β-重型地中海贫血(β-TM)心肌、肝脏、胰腺铁沉积,观察其与糖代谢的相关性。方法回顾性分析109例β-TM患者,其中91例于MR检查前后2周内接受空腹血糖检测,根据检测结果将其分为血糖升高组(n=19)及血糖正常组(n=72),比较组间临床资料及MRI指标差异,分析心肌、肝脏、胰腺R2*值(1/T2^(*))与血糖代谢指标的相关性。采用Logistics回归分析糖代谢异常的危险因素,绘制心肌、肝脏、胰腺R2*预测血糖升高的受试者工作特征(ROC)曲线,评价其诊断效能。结果109例β-TM患者心肌T2^(*)值27.72(15.87,31.16)ms,肝脏T2^(*)值1.71(1.34,3.07)ms,胰腺T2^(*)值6.09(3.76,15.02)ms。血糖升高组与血糖正常组间年龄、输血年限、总输入铁量、去铁年限、空腹血糖、胰岛素抵抗指数、心肌R2*及胰腺R2*差异均有统计学意义(P均<0.05)。心肌及胰腺R2*均与空腹血糖呈正相关(r=0.36、0.41,P均<0.01),肝脏R2*与空腹血糖无明显相关(P=0.76)。肝脏R2*、胰腺R2*均为糖代谢异常危险因素(P均<0.05)。心肌及胰腺R2*预测空腹血糖升高的曲线下面积(AUC)均为0.80(P均<0.01)。结论心肌、胰腺铁沉积与β-TM血糖代谢存在一定相关性;心肌和胰腺R2*预测β-TM血糖升高的诊断效能佳。Objective To quantitatively analyze iron deposition in myocardium,liver and pancreas ofβ-thalassemia major(β-TM)with MRI-T2^(*)and the relationships with glucose metabolism.Methods MRI and clinical data of 109β-TM patients were retrospectively analyzed,including 91 patients underwent fasting blood glucose test within 2 weeks before or after MR examination and divided into hyperglycemia group(n=19)or euglycemia group(n=72).The clinical and MRI indexes were compared between 2 groups,and the correlations of R2*values(1/T2^(*))of myocardium,liver and pancreas and glucose metabolism indexes were analyzed.Logistic regression analysis was used to find the risk factors of abnormal glucose metabolism.Receiver operating characteristic(ROC)curves of R2*in myocardial,liver and pancreas for predicting elevated blood glucose were drawn to evaluate the diagnostic efficacy.Results T2^(*)values of myocardium,liver and pancreas in 109 patients were 27.72(15.87,31.16)ms,1.71(1.34,3.07)ms and 6.09(3.76,15.02)ms,respectively.There were statistical differences of age,duration of blood transfusion,total amount of iron input,duration of iron removal,fasting blood glucose,homeostatic model assessment for insulin resistance,myocardial R2*and pancreatic R2*between 2 groups(all P<0.05).Both myocardium and pancreas R2*were positively correlated with fasting blood glucose(r=0.36,0.41,both P<0.01),while hepatic R2*was not significantly correlated with fasting blood glucose(P=0.76).Liver R2*and pancreas R2*were risk factors for abnormal glucose metabolism(both P<0.05).The area under the curve(AUC)of myocardium R2*and pancreas R2*for predicting fasting glucose elevation was both 0.80(all P<0.01).Conclusion Myocardium and pancreas iron deposition were correlated withβ-TM glucose metabolism to a certain extent.Myocardium and pancreas R2*were effective in predictingβ-TM blood glucose increasing.

关 键 词：Β地中海贫血 胰腺 铁 磁共振成像 葡萄糖代谢障碍 

分 类 号：R556[医药卫生—血液循环系统疾病] R445.2[医药卫生—内科学]