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铁的非侵入性测量:美国国立糖尿病、消化和肾脏疾病研究所研讨会报告

Noninvasive measurement of iron: report of an NIDDK workshop.

作者信息

Brittenham Gary M, Badman David G

机构信息

Columbia University College of Physicians and Surgeons, New York, NY, USA.

出版信息

Blood. 2003 Jan 1;101(1):15-9. doi: 10.1182/blood-2002-06-1723. Epub 2002 Aug 29.

Abstract

An international workshop on the noninvasive measurement of iron was conducted by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) on April 17, 2001, to assess the current state of the science and to identify areas needing further investigation. The workshop concluded that a clear clinical need is evident for quantitative, noninvasive, safe, accurate, and readily available means of measuring body storage iron to improve the diagnosis and management of patients with iron overload from such disorders as hereditary hemochromatosis, thalassemia major, sickle cell disease, aplastic anemia, and myelodysplasia, among others. Magnetic resonance imaging (MRI) potentially provides the best available technique for examining the 3-dimensional distribution of excess iron in the body, but further research is needed to develop means of making measurements quantitative. Biomagnetic susceptometry provides the only noninvasive method to measure tissue iron stores that has been calibrated, validated, and used in clinical studies, but the complexity, cost, and technical demands of the liquid-helium-cooled superconducting instruments required at present have restricted clinical access to the method. The workshop identified basic and clinical research opportunities for deepening our understanding of the physical properties of iron and iron toxicity, for further investigation of MRI as a method for quantitative determinations of tissue iron, especially in liver, heart and brain, and for development of improved methods and more widely available instrumentation for biomagnetic susceptometry.

摘要

2001年4月17日,美国国立糖尿病、消化和肾脏疾病研究所(NIDDK)举办了一次关于铁的非侵入性测量的国际研讨会,以评估当前的科学现状,并确定需要进一步研究的领域。研讨会得出结论,对于测量体内储存铁的定量、非侵入性、安全、准确且易于获得的方法,有着明显的临床需求,这有助于改善对患有遗传性血色素沉着症、重型地中海贫血、镰状细胞病、再生障碍性贫血和骨髓增生异常综合征等疾病导致铁过载患者的诊断和管理。磁共振成像(MRI)可能提供了检查体内过量铁三维分布的最佳现有技术,但需要进一步研究以开发进行定量测量的方法。生物磁测量法是唯一一种已校准、验证并用于临床研究的测量组织铁储存的非侵入性方法,但目前所需的液氦冷却超导仪器的复杂性、成本和技术要求限制了该方法的临床应用。研讨会确定了基础和临床研究机会,以加深我们对铁的物理性质和铁毒性的理解,进一步研究将MRI作为定量测定组织铁的方法,特别是在肝脏、心脏和大脑中,以及开发改进的生物磁测量法方法和更广泛可用的仪器。

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