Department of Radiology, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK.
Eur J Radiol. 2011 Nov;80(2):204-7. doi: 10.1016/j.ejrad.2010.05.010. Epub 2010 Jun 8.
The aim of this study was to determine if changes in hepatic iron content in patients with hemochromatosis pre- and post-venesection could be detected by changes in liver signal intensity with MRI.
The study was performed with institutional ethics approval and with informed consent. Gradient echo images were performed on 20 patients with hemochromatosis pre- and post-venesection and 10 control subjects: gradient echo T1-weighted in- and out-phases (4.54 (in)/2.27 (out), 167 [TE/TR], Flip 70°) and gradient echo T2* (5/18 [TE/TR], Flip 10°). The liver to muscle signal ratio was compared pre- and post-venesection.
All MRI sequences showed significant correlation between the liver to muscle signal intensity ratio and the serum ferritin pre-venesection [r=-0.70, -0.65, -0.74, -0.72, in/out/T2r/T2, respectively]. There was a significant increase on all sequences in the liver to muscle signal intensity ratio post-venesection (p<0.001). The control group and patients post-venesection had almost identical liver to muscle signal intensity ratios.
The reduction in liver signal intensity caused by iron excess in hemochromatosis returns to normal post-venesection. Measurement of liver to muscle signal intensity ratios may be a useful tool in assessing treatment response in iron overload states.
本研究旨在通过 MRI 检测肝铁含量在血吸前后的变化，确定是否能检测到血色病患者肝铁含量的变化。
本研究经机构伦理审查批准，并获得了患者知情同意。对 20 例血色病患者血吸前后及 10 例对照者进行梯度回波成像：梯度回波 T1 加权同、反相位（4.54 [in]/2.27 [out]，167 [TE/TR]，翻转 70°）和梯度回波 T2*（5/18 [TE/TR]，翻转 10°）。比较血吸前后肝与肌肉的信号强度比。
所有 MRI 序列均显示肝与肌肉的信号强度比与血吸前血清铁蛋白之间存在显著相关性[分别为 r=-0.70、-0.65、-0.74、-0.72、in/out/T2r/T2]。血吸后所有序列的肝与肌肉信号强度比均显著升高（p<0.001）。对照组和血吸后的患者肝与肌肉的信号强度比几乎相同。
血色病中因铁过量导致的肝信号强度降低，在血吸后恢复正常。肝与肌肉信号强度比的测量可能是评估铁过载状态治疗反应的有用工具。
