利用 T2* 磁共振成像评估输血依赖型地中海贫血患者的心脏、肝脏和胰腺铁负荷过重情况

Vijay Ramanan, Kanchankumar Ramrao Bhagyawant, Onkar Auti, Pratibha Gawande
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摘要

我们计划用T2*磁共振成像评估年轻输血依赖型地中海贫血(TDT)患者的铁超载情况,并与血清铁蛋白相关联。本研究纳入了2017年7月至2018年12月在一家三级医疗机构接受定期输血的3至38岁年轻TDT患者。对所有患者进行了T2*磁共振成像,并与血清铁蛋白值进行了相关分析。在一年半的时间里,193 例患者中有 26 例(13.4%)表现为轻度肝铁超载,48 例(24.8%)为中度肝铁超载,92 例(47.6%)为重度肝铁超载。129例患者未发现心脏铁负荷过重,21例为轻度,12例为中度,31例为重度。胰腺铁超载:67 例未发现,35 例轻度,43 例中度,33 例重度,15 例无法检测。血清铁蛋白水平与肝脏 T2* 呈强负相关。血清铁蛋白与心脏 T2* 呈中度负相关。胰腺铁超载与年龄组之间存在统计学差异(P 值 = 0.001)。此外,血清铁蛋白水平与 T2* 磁共振成像数据确定的铁超载之间存在显著相关性。
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Assessment of Cardiac, Hepatic and Pancreatic Iron Overload in Transfusion Dependent Thalassemia Patients Using T2* Magnetic Resonance Imaging

We planned to assess iron overload in young transfusion-dependent thalassemia (TDT) patients with T2* MRI and correlate with serum ferritin. This study included young TDT patients aged 3 to 38 years on regular transfusion in a tertiary care facility from July 2017 to December 2018. T2* MRI was performed on all patients and correlated with serum ferritin values. Out of 193 cases over a period of one and half year, 26 (13.4%) cases showed mild, 48 (24.8%) moderate, and 92 (47.6%) cases showed severe hepatic iron overload. Cardiac iron overload detected none in 129, mild in 21, moderate in 12, severe in 31 patients. Pancreatic iron overload was observed none in 67, mild 35, moderate in 43, severe in 33 patients and could not be done in 15 patients. There is strong negative correlation between serum ferritin level and liver T2*. Moderate negative correlation of serum ferritin was found with cardiac T2*. Statistically significant difference was observed between pancreas iron overload and age group (P-value = 0.001). The results of this study are comparable with those of several earlier studies In addition, there is a significant correlation between serum ferritin levels and iron overload determined by T2* MRI data.

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期刊介绍: Indian Journal of Hematology and Blood Transfusion is a medium for propagating and exchanging ideas within the medical community. It publishes peer-reviewed articles on a variety of aspects of clinical hematology, laboratory hematology and hemato-oncology. The journal exists to encourage scientific investigation in the study of blood in health and in disease; to promote and foster the exchange and diffusion of knowledge relating to blood and blood-forming tissues; and to provide a forum for discussion of hematological subjects on a national scale. The Journal is the official publication of The Indian Society of Hematology & Blood Transfusion.
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