MR磁量图对自发性脑出血患者脑铁过量沉积的定量研究

A quantitative susceptibility mapping of brain iron overload in spontaneous intracerebral hemorrhage: a quantitative 3T MRI study

目的通过对比健康志愿者与自发性脑出血(ICH)患者苍白球(GP)磁化率的差异,探讨MR磁量图(QSM)对GP非血红素铁的定量评估反映脑可能损伤或退化的潜在价值。材料与方法 21例ICH患者及20名健康对照组接受了CT及MR多回波QSM检查。在QSM图上定量检测两组受检者GP区的磁化率,采用Mann-Whitney检验比较两组GP磁化率之间的差异,Pearson相关分析GP磁化率与T2SI及年龄之间的相关性;Spearman相关分析GP磁化率与发病时间之间的相关性。结果 ICH组及对照组之间GP区磁化率(330.92,270.74～510.83;287.34,172.47～319.98)存在显著性差异(Z=-4.147,P<0.05),且ICH组GP区磁化率与其T2信号强度(T2SI)(359.40,281.70～436.50)之间呈明显负相关(r=-0.715,P<0.01),与血肿发病时间(338h,1～1800h)呈轻度正相关(r=0.434,P<0.05)。所有受检者GP磁化率与年龄(ICH组及对照组分别为66,50～89;66,51～82)之间无明显相关(P>0.05)。结论 GP区脑铁过量沉积有可能提示脑损伤或功能退化的程度,QSM对GP非血红素铁的定量评估可作为ICH患者脑细胞内铁过量的参考指标之一。

Objective： To evaluate the potential value of the brain iron overload deposition of globus pallidus （GP） in patients with spontaneous intracerebral hemorrhage （ICH） by quantitative susceptibility mapping （QSM）. Materials and Methods： The data of 21 patients with ICH and 20 healthy controls（HC） who had MR multi-echo QSM and CT performed were retrospectively analysized. The magnetic susceptibility of GP was quantitative detected in all cases. The difference of magnetic susceptibility was analysized between ICH and HC with Mann-Whitney test. Correlation analysis was performed between the magnetic susceptibility of GP, T2SI and age with Pearson. Spearman correlation analysis was performed between the magnetic susceptibility of GP and onset time. Results： The difference of the magnetic susceptibility in GP was observed between ICH group and HC （Z =--4.147 P〈0.05）. The magnetic susceptibility of GP was negatively correlated with T2SI （r=--0.715） and positively correlated with time of onset （r=0.434）in ICH group. However, no relationships was detected between the magnetic susceptibility and age （P〉0.05）in all cases. Conclusions： The iron overload of GP may be a predictor of the brain damage and neurodegenerative. The quantitative assessment of non-heme iron overload in GP by QSM may be one of the indicators refer in the ICH patients.