Mankad V N, Williams J P, Harpen M D, Manci E, Longenecker G, Moore R B, Shah A, Yang Y M, Brogdon B G
Comprehensive Sickle Cell Center, University of South Alabama, Mobile.
Blood. 1990 Jan 1;75(1):274-83.
A longitudinal, prospective, controlled evaluation of magnetic resonance images (MRI) of long bones in sickle cell patients was undertaken simultaneously with assessment of clinical status and hematologic parameters, including dense erythrocytes. MRI of bone marrow in sickle cell patients during steady states appeared patchy and were markedly different from those in matched controls (P approximately 0). Patients with severe patchiness were older than those with mild or moderate patchiness (P less than .03). Sixty-nine MRI were performed during 28 painful episodes occurring in 14 subjects with sickle cell disease (SCD). Increased signals on intermediate and T2-weighted images were detected in 35.7% of painful episodes. These abnormalities were distinct and not observed to occur spontaneously during the steady-state examinations (P approximately 0). Bone marrow infarcts were confirmed by biopsy in two instances and autopsy in one instance. Dense red cells decreased by 40.81% of baseline during pain crises (P = .00005), more remarkably in those who had pain in the lower extremities (P = .0145). Patients with change in MRI during pain crises had a greater percentage change in the dense cells than those without the change in MRI (69.7% v 31.3%, P = .0120).
对镰状细胞病患者的长骨进行了纵向、前瞻性、对照性磁共振成像（MRI）评估，同时评估了临床状况和血液学参数，包括致密红细胞。镰状细胞病患者稳定期的骨髓MRI表现为斑片状，与匹配的对照组明显不同（P约为0）。重度斑片状的患者比轻度或中度斑片状的患者年龄更大（P<0.03）。对14例镰状细胞病（SCD）患者发生的28次疼痛发作期间进行了69次MRI检查。在35.7%的疼痛发作中检测到中间加权和T2加权图像上信号增强。这些异常很明显，在稳定期检查中未观察到自发出现（P约为0）。通过活检证实了2例骨髓梗死，通过尸检证实了1例。在疼痛危象期间，致密红细胞比基线水平下降了40.81%（P = 0.00005），在下肢疼痛的患者中下降更为明显（P = 0.0145）。疼痛危象期间MRI有变化的患者，其致密细胞的百分比变化大于MRI无变化的患者（69.7%对31.3%，P = 0.0120）。
