磁共振成像技术对血液病长期输血患者肝脏铁沉积状况的评估

Evaluation of liver iron deposition status in patients with long-term blood transfusion for blood disease by MRI T2 technique

目的：探讨磁共振（ MRI）成像技术对血液病长期输血患者全肝脏铁沉积状况的评估价值。方法选取因血液病长期输血的患者100例及正常人30例为研究对象，将患者按输血量进行分组，行MRI全肝铁功能成像检查，根据MRI T2值纳入肝脏铁过载的患者，检测其血清铁蛋白（ SF），分析SF与MRI T2值的相关性。对符合去铁治疗标准的患者予以去铁胺干预，治疗1、3个月后检测SF和MRI T2值，观察铁沉积的转归。结果经MRI检测，100例患者中有82例为肝脏铁过载，其血清铁蛋白值明显高于正常人，且与肝脏 MRI T2值呈负相关（ r =-0.709，P=0.00）。其中76例患者接受去铁治疗，与治疗前相比，治疗后1、3个月SF水平明显降低（P﹤0.05），肝脏MRI T2值明显升高（P﹤0.05）。治疗后3个月的总反应率与1个月时比较，差异有统计学意义（P﹤0.05）。结论 MRI成像在评估血液病长期输血患者全肝脏铁沉积状况方面有重要的临床价值。

Objective To study the evaluation value of MRI T2 technique on liver iron deposi-tion status in patients with long-term blood transfusion for blood disease. Methods One hundred pa-tients with long-term blood transfusion for blood disease and 30 healthy persons were included in this study. The liver iron deposition status of 100 patients were divided into 5 groups according to their volume of blood transfusion. Serum ferritin levels of the patients with liver iron overload were measured and the correlation between the levels of SF and values of liver MRI T2 was analyzed. The patients who met the standard of iron chelation therapy received the treatment of deferoxamine. The levels of SF and values of liver MRI T2 were tested after 1 month and 3 months of treatment and the development of iron deposition was observed. Results The levels of SF of 82 patients with liver iron overload were significantly higher than those of healthy persons and were negatively related to the values of liver MRI T2（ r= -0. 709 ,P=0. 00 ）. Seventy-six patients received the treatment of deferoxamine and their levels of SF were significant-ly decreased（ P﹤0. 05 ）,and the values of liver MRI T2 were significantly increased（ P﹤0. 05 ）after 1 month and 3 months compared with the results before treatment. There was significant differences in the total reaction rate between 3 months and 1 month after treatment（ P﹤0. 05 ）. Conclusions The clinical evaluation value of MRI T2 technique on liver iron deposition status in patients with long-term blood transfusion for blood disease is high.