Center for Liver Disease, Digestive Disease Institute and Benaroya Research Institute at Virginia Mason Medical Center, Seattle, WA, USA.
Ann Hepatol. 2012 Jan-Feb;11(1):77-84.
There is an ongoing clinical need for novel methods to measure hepatic iron content (HIC) noninvasively. Both magnetic resonance imaging (MRI) and superconducting quantum interference device (SQUID) methods have previously shown promise for estimation of HIC, but these methods can be expensive and are not widely available. Room-temperature susceptometry (RTS) represents an inexpensive alternative and was previously found to be strongly correlated with HIC estimated by SQUID measurements among patients with transfusional iron overload related to thalassemia.
The goal of the current study was to examine the relationship between RTS and biochemical HIC measured in liver biopsy specimens in a more varied patient cohort.
Susceptometry was performed in a diverse group of patients with hyperferritinemia due to hereditary hemochromatosis (HHC) (n = 2), secondary iron overload (n = 3), nonalcoholic fatty liver disease (NAFLD) (n = 2), and chronic viral hepatitis (n = 3) within one month of liver biopsy in the absence of iron depletion therapy.
The correlation coefficient between HIC estimated by susceptometry and by biochemical iron measurement in liver tissue was 0.71 (p = 0.022). Variance between liver iron measurement and susceptometry measurement was primarily related to reliance on the patient's body-mass index (BMI) to estimate the magnetic susceptibility of tissue overlying the liver.
We believe RTS holds promise for noninvasive measurement of HIC. Improved measurement techniques, including more accurate overlayer correction, may further improve the accuracy of liver susceptometry in patients with liver disease.
目前临床上需要新的方法来无创地测量肝铁含量(HIC)。磁共振成像(MRI)和超导量子干涉装置(SQUID)方法此前已显示出用于估计 HIC 的潜力,但这些方法可能昂贵且不广泛可用。室温磁化率(RTS)代表了一种廉价的替代方法,先前发现它与 SQUID 测量估计的 HIC 在因地中海贫血导致的输血性铁过载的患者中具有很强的相关性。
本研究的目的是在更具异质性的患者群体中检查 RTS 与肝活检标本中生化 HIC 之间的关系。
在肝活检后一个月内,对因遗传性血色病(HHC)(n=2)、继发性铁过载(n=3)、非酒精性脂肪性肝病(NAFLD)(n=2)和慢性病毒性肝炎(n=3)而出现高血铁蛋白血症的患者进行磁化率测定。在没有铁耗竭治疗的情况下。
磁化率测定估计的 HIC 与肝组织生化铁测定之间的相关系数为 0.71(p=0.022)。肝铁测量和磁化率测量之间的方差主要与依赖患者的体重指数(BMI)来估计肝脏上方组织的磁化率有关。
我们认为 RTS 有希望用于无创测量 HIC。改进的测量技术,包括更准确的覆盖层校正,可能会进一步提高肝脏磁化率在肝病患者中的准确性。