Pancreatic iron stores assessed by magnetic resonance imaging (MRI) in beta thalassemic patients
Pancreatic iron stores assessed by magnetic resonance imaging (MRI) in beta thalassemic patients
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DOI：
10.1016/j.ejrad.2011.03.077
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发表时间：
2012-07-01
影响因子：
3.3
通讯作者：
Hamerschlak, Nelson
中科院分区：
文献类型：
--
作者：
de Assis, Reijane Alves;Feitosa Ribeiro, Andreza Alice;Hamerschlak, Nelson
目的：评估β地中海贫血患者胰腺MRI表现与心脏和肝脏MRI表现之间的相关性;比较胰腺T2* MRI结果与葡萄糖和铁蛋白水平以及不稳定血浆铁（LPI）。材料和方法：我们回顾性评估了长期输血的患者，用酶试验检测葡萄糖，用化学发光法检测血清铁蛋白，用细胞荧光法检测LPI，和T2* MRI以评估心脏、肝脏和胰腺中的铁含量。将MRI结果相互比较，并与血糖、铁蛋白和LPI进行比较。采用原子吸收光谱法测定11例患者肝活检组织中的肝铁浓度（LIC）。9.4%的患者有明显的糖尿病，另外16%的患者有空腹血糖受损。胰腺和心脏R2* 对识别糖尿病具有预测能力（p < 0.0001）。心脏和胰腺的R2* 彼此适度相关（r（2）= 0.20，p < 0.0001）。两者均与LIC（两者均为r（2）= 0.09，p < 0.0001）和血清铁蛋白（分别为r（2）= 0.14，p < 0.0001和r（2）= 0.03，p < 0.02）弱相关。这三种方法都不能作为单一观察的筛选工具。信号强度比（SIR）值与胰腺R2* 之间存在较强的双对数或幂律关系，r（2）为0.91。结论：胰腺铁超载可以通过MRI评估，但其他器官的含铁血黄素沉着症与胰腺含铁血黄素沉着症无明显相关性。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Purpose: To assess the correlation between MRI findings of the pancreas with those of the heart and liver in patients with beta thalassemia; to compare the pancreas T2* MRI results with glucose and ferritin levels and labile plasma iron (LPI).Materials and methods: We retrospectively evaluated chronically transfused patients, testing glucose with enzymatic tests, serum ferritin with chemiluminescence, LPI with cellular fluorescence, and T2* MRI to assess iron content in the heart, liver, and pancreas. MRI results were compared with one another and with serum glucose, ferritin, and LPI. Liver iron concentration (LIC) was determined in 11 patients' liver biopsies by atomic absorption spectrometry.Results: 289 MRI studies were available from 115 patients during the period studied. 9.4% of patients had overt diabetes and an additional 16% of patients had impaired fasting glucose. Both pancreatic and cardiac R2* had predictive power (p < 0.0001) for identifying diabetes. Cardiac and pancreatic R2* were modestly correlated with one another (r(2) = 0.20, p < 0.0001). Both were weakly correlated with LIC (r(2) = 0.09, p < 0.0001 for both) and serum ferritin (r(2) = 0.14, p < 0.0001 and r(2) = 0.03, p < 0.02, respectively). None of the three served as a screening tool for single observations. There is a strong log-log, or power-law, relationship between ratio of signal intensity (SIR) values and pancreas R2* with an r(2) of 0.91.Conclusions: Pancreatic iron overload can be assessed by MRI, but siderosis in other organs did not correlate significantly with pancreatic hemosiderosis. (C) 2011 Elsevier Ireland Ltd. All rights reserved.