磁敏感加权成像检测肝豆状核变性患者脑铁沉积及其与铁代谢关系的研究  

Study on the Relationship Between Brain Iron Deposition and Iron Metabolism in Patients with Wilson’s Disease by Susceptibility Weighted Imaging

作　　者：孙兰婷 汪瀚[1] 徐春生[2] 何望生[1] 李晓韵 SUN Lanting;WANG Han;XU Chunsheng(The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui Province 230031,P.R.China)

机构地区：[1]安徽中医药大学第一附属医院脑病中心,合肥230031 [2]安徽中医药大学第一附属医院影像中心,合肥230031 [3]安徽中医药大学研究生院

出　　处：《临床放射学杂志》2021年第9期1666-1669,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金(编号:81973825);安徽省高校自然科学研究基金资助项目(编号:KJ2020A0436)。

摘　　要：目的利用磁敏感加权成像(SWI)检测肝豆状核变性(WD)患者脑铁沉积,并研究脑铁含量与外周铁代谢指标之间的关系。方法 (1)连续搜集初次就诊的60例WD患者(WD组)及32例年龄、性别匹配的健康体检者(NC组),采用SWI扫描两组受试者双侧壳核(PUT)、苍白球(GP)、尾状核头(HCN)、丘脑(THA)、黑质(SN)、红核(RN),测量其校正相位(CP)值,并比较两组CP值的差异。(2)在完成SWI检测的当天测定血清铁、铁蛋白、转铁蛋白及24 h尿铁的水平,对两组上述指标进行对比分析。(3)对WD组各核团CP值与铁代谢相关蛋白指标进行相关性分析。结果 (1)WD组各核团CP值明显低于NC组(P<0.01)。(2)WD组铁蛋白水平明显高于NC组(P<0.05),转铁蛋白水平明显低于NC组(P<0.05),血清铁及24 h尿铁差异均无统计学意义(P>0.05)。(3)WD组各核团的CP值与铁蛋白呈显著负相关(P<0.05),与转铁蛋白呈显著正相关(P<0.05)。结论 WD患者存在脑铁蓄积及铁代谢指标的异常,且两者紧密相关。SWI是检测WD患者脑铁沉积的有效、无创手段,能为WD临床诊断及病情监测提供依据。Objective To detect iron deposition in brain of patients with Wilson’s disease(WD) by susceptibility weighted imaging(SWI),and to study the relationship between iron content in brain and peripheraliron metabolism. Methods(1) Sixty WD patients(WD group) and 32 age and gender matched healthy subjects(NC group) whovisitedthe Encephalopathy Center of the First Affiliated Hospital of Anhui University of Chinese Medicine for the first time from June 2019 to December 2020 were collected consecutively.SWI was used to scan bilateral putamen(PUT),globus pallidus(GP),the head of caudate nucleus(HCN),thalamus(THA),substantia nigra(SN) and red nucleus(RN) of subjects in the two groups, and the correction phase(CP) values were measured, and the differences of CP values between the two groups were compared.(2) The levels of serum iron, ferritin, transferrin and 24 h urinary iron were measured on the day of completion of SWI test, and the above indexes of the two groups were compared and analyzed.(3) Correlation analysis was conducted between CP values of each nucleus and iron metabolism-related protein indexes in WD group. Results(1) The CP value of each nucleus in WD group was significantly lower than that in NC group(P<0.01).(2) The ferritin level in WD group was significantly higher than that in NC group(P<0.05),and the transferrin level was significantly lower than that in NC group(P<0.05).There were no significant differences in serum iron and 24 h urinary iron(P>0.05).(3) The CP values of each nucleus in WD group were significantly negatively correlated with ferritin(P<0.05),and positively correlated with transferrin(P<0.05). Conclusion There are abnormal iron accumulation and iron metabolism indexes in WD patients, and they are closely related.SWI is an effective and non-invasive method to detect brain iron deposition in WD patients, which can provide a basis for clinical diagnosis and disease monitoring of WD.

关 键 词：肝豆状核变性 磁敏感加权成像 脑铁含量 铁代谢 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.4[医药卫生—诊断学]