Sparacia G, Midiri M, D'Angelo P, Lagalla R
Institute of Radiology P. Cignolini, University of Palermo, Italy.
MAGMA. 1999 May;8(2):87-90. doi: 10.1007/BF02590524.
To identify pituitary iron overload in patients with transfusional hemochromatosis causing secondary hypogonadism, we prospectively evaluated signal intensity abnormalities of the anterior lobe of the pituitary gland of 18 patients affected by transfusion-dependent thalassemia major and secondary hypogonadism. Magnetic resonance (MR) imaging is useful to assess pituitary iron overload in patients with transfusional hemochromatosis and secondary hypogonadism by detection of a significant decreased signal intensity of the anterior lobe of the pituitary gland on GRE T2*-weighted images. The decreased signal intensity of the anterior lobe of the pituitary gland on GRE T2*-weighted images was correlated to increasing serum ferritin level (r = -0.84, r2 = -0.70, P < 0.001). Indeed, the lower the signal intensity of the pituitary gland, the greater the serum ferritin level. However an exact quantification of pituitary iron overload by correlation with serum ferritin level is not allowed. No correlation was found between MR imaging results and hormonal status; however, the detection of pituitary iron overload on GRE T2*-weighted images is consistent with the hypothesis of hypogonadotrophic pituitary insufficiency due to iron-induced cellular damage.
为了识别因输血性血色素沉着症导致继发性性腺功能减退患者的垂体铁过载，我们前瞻性评估了18例依赖输血的重型地中海贫血和继发性性腺功能减退患者垂体前叶的信号强度异常。磁共振（MR）成像通过检测GRE T2 *加权图像上垂体前叶明显降低的信号强度，有助于评估输血性血色素沉着症和继发性性腺功能减退患者的垂体铁过载。GRE T2 *加权图像上垂体前叶信号强度降低与血清铁蛋白水平升高相关（r = -0.84，r2 = -0.70，P < 0.001）。实际上，垂体信号强度越低，血清铁蛋白水平越高。然而，无法通过与血清铁蛋白水平的相关性对垂体铁过载进行精确量化。未发现MR成像结果与激素状态之间存在相关性；然而，在GRE T2 *加权图像上检测到垂体铁过载与铁诱导的细胞损伤导致的低促性腺激素性垂体功能不全的假设一致。
