剪切波弹性成像评估重型β-地中海贫血患儿肝脏超铁负荷:与肝脏MR T2^(*)值及血清铁蛋白的相关性

Shear wave elastography for evaluating hepatic iron overload in children withβ-thalassemia major:Correlations with MR T2^(*)value and serum ferritin

目的观察剪切波弹性成像(SWE)评估重型β-地中海贫血(β-TM)患儿超铁负荷的价值,及其参数与肝脏MR T2^(*)值及血清铁蛋白的相关性。方法回顾性分析96例β-TM患儿及100名健康儿童(对照组),根据是否接受造血干细胞移植(HSCT)将患儿分为HSCT组(n=41)或无HSCT组(n=55),比较3组SWE参数;采用Spearman相关分析观察肝脏剪切波速度(LSWV)与肝脏MR T2^(*)值及血清铁蛋白、杨氏模量与肝脏MR T2^(*)值及血清铁蛋白的相关性。结果HSCT组、无HSCT组LSWV及杨氏模量均高于对照组(P均<0.001);HSCT组与无HSCT组LSWV及杨氏模量差异均无统计学意义(P均>0.05)。β-TM患儿SWE参数与MR T2^(*)值均呈中度负相关(r=-0.501,P<0.05;r=-0.514,P<0.05)、与血清铁蛋白均呈低度正相关(r=0.488,P<0.05;r=0.470,P<0.05)。结论SWE可用于评估β-TM患儿肝脏超铁负荷;SWE参数与MR T2^(*)值呈负相关、与血清铁蛋白呈正相关。

Objective To observe the value of shear wave elastography(SWE)for evaluating hepatic iron overload in children withβ-thalassemia major(β-TM),as well as the correlations of relative parameters with MR T2^(*)value and serum ferritin.Methods Totally 96 children withβ-TM and 100 healthy children(control group)were retrospectively enrolled.Children withβ-TM were divided into hematopoietic stem cell transplantation(HSCT)group(n=41)or non-HSCT group(n=55)according to underwent HSCT or not.SWE parameters were compared among groups.Spearman correlation was performed to observe the correlations of liver shear wave velocity with MR T2^(*)value and serum ferritin,as well as Young's modulus with MR T2^(*)value and serum ferritin in children withβ-TM.Results Liver shear wave velocity(LSWV)and Young's modulus in HSCT group and non-HSCT group were all higher than those in control group(all P<0.001).No significant difference of LSWV nor Young's modulus was found between HSCT group and non-HSCT group(both P>0.05).SWE parameters of children withβ-TM were moderately and negatively correlated with MR T2^(*)value(r=-0.501,P<0.05;r=-0.514,P<0.05),while weakly and positively correlated with serum ferritin(r=0.488,P<0.05;r=0.470,P<0.05).Conclusion SWE was helpful for evaluating hepatic iron overload in children withβ-TM,with parameters being negatively correlated with MR T2^(*)value and positively correlated with serum ferritin.