摘要
目的探讨水脂分离定量技术mDIXON-Quant序列评价输血依赖性疾病患者肝脏和胰腺铁沉积的应用价值。方法前瞻性收集2016年12月至2018年5月天津市第一中心医院未经祛铁治疗的输血依赖性患者34例,按照输血量分为少量输血组23例(3年内输血量2 000~5 000 ml)及大量输血组11例(3年输血量>5 000 ml)。所有患者均行常规三维MR梯度回波(FFE)序列和mDIXON-quant序列扫描,分别获得肝脏、胰腺的T2^* map图像,得到基于上述两种序列的R2^*值,分别记为R2^*和dR2^*。采用Pearson法分析各组肝脏和胰腺的R2^*、dR2^*值的相关性,并分析R2^*、dR2^*值与输血量的相关性。采用配对t检验比较相同输血量患者R2^*、dR2^*值的差异。结果(1)少量输血组:肝脏和胰腺的R2^*、dR2^*值间均具有高度相关性(r值分别为0.993、0.962,P<0.01);肝脏、胰腺的R2^*值和dR2^*与输血量均无相关性(P均>0.05);肝脏和胰腺的R2^*值和dR2^*值间,差异均无统计学意义(P均>0.05)。(2)大量输血组:当T2^*<1.8 ms时,T2^*map较dT2^*map信噪比低,噪声严重影响T2^*值测量;T2^*≥1.8 ms时,肝脏和胰腺的R2^*、dR2^*值间均具有高度相关性(r值分别为0.991、0.989,P<0.01)。肝脏的R2^*值和dR2^*值均与输血量呈正相关(r值分别为0.527、0.639,P均<0.01);胰腺的R2^*值和dR2^*值也均与输血量呈正相关(r值分别为0.590、0.602,P均<0.01)。肝脏的R2^*值和dR2^*值间,差异有统计学意义(P<0.01),胰腺的R2^*值和dR2^*值间,差异无统计学意义(P>0.05)。结论mDIXON-quant序列与三维FFE序列均可用于输血依赖性患者肝脏、胰腺的铁定量评估。对于大量输血的铁过载患者,采用mDIXON-quant序列评价肝脏、胰腺铁沉积严重程度更具优势。
Objective To explore the clinical value of mDIXON-Quant sequence in the quantitative evaluation of transfusion dependent patients with liver and pancreas iron deposition. MethodProspective collection of 34 transfusion dependent patients from December 2016 to May 2018 in Tianjin First Central Hospital who had not undergone iron chelation therapy was conducted in this study. According to the volume of blood transfusion,the subjects were divided into small amount of blood transfusion group (23 cases with blood transfusion of 2 000 to 5 000 ml within 3 years) and massive blood transfusion group (11 cases with blood transfusion of greater than 5 000 ml within 3 years). All patients underwent MR examinations using a Philips Ingenia 3.0 T MR scanner with multi-echo 3D-fast field echo (FFE) and 3D mDIXON-Quant protocols. For 3D multi-echo FFE images,the R2^*(R2^*=1/T2^*) of liver and pancreas were calculated voxel by voxel. For mDIXON-Quant images,the dR2^*(d R2^*=1/dT2^*),which was different from the R2^* with 3D multi-echo FFE,was calculated within liver and pancreas voxel by voxel. Pearson correlation was performed to investigate the relationship between the R2^* value and dR2^* value of liver and pancreas in each group,and between the R2^*(and dR2^*) of liver and pancreas with the volume of blood transfusion. A paired t test was used to compare the values of R2^* and dR2^* in the same patient. ResultsFor small amount of blood transfusion group:liver and pancreas R2^* and dR2^* values were significantly correlated with the correlation coefficients of 0.993 and 0.962 respectively. There was no correlation between the value of liver and pancreas and the amount of blood transfusion (P>0.05). There was no significant difference in R2^* and dR2^* values in liver and pancreas (P>0.05). For massive blood transfusion group:when T2^* was smaller than 1.8 ms,the SNR of T2^*maps was lower than that of dT2^*maps,and the noise seriously affects the T2^* measurements. When T2^* was greater than 1.8 ms:liver and pancreas R2^* and dR
作者
吴巧玲
张晓琦
倪红艳
Wu Qiaoling;Zhang Xiaoqi;Ni Hongyan(Tianjin University of Traditional Chinese Medicine,Tianjin 300192,China;Department of Radiology,Jining First People′s Hospital,Shandong Province,Jining 272002,China;Department of Radiology,Tianjin First Central Hospital,Tianjin 300192,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2019年第6期470-474,共5页
Chinese Journal of Radiology
基金
天津市卫生行业重点攻关课题(15KG134).
关键词
输血
铁沉积
磁共振成像
肝脏
胰腺
Blood transfusion
Iron deposition
Magnetic resonance imaging
Liver
Pancreas
