Youssef Doaa Mohammed, Fawzy Mohammad Faten, Ahmed Fathy Ayman, Aly Abdelbasset Maha
Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
ISRN Hematol. 2013 Mar 28;2013:496985. doi: 10.1155/2013/496985. Print 2013.
Background. MRI has emerged for the noninvasive assessment of iron overload in various tissues. The aim of this paper is to evaluate hepatic and pancreatic iron overload by T2(∗) weighted gradient echo MRI in young beta-thalassemia major patients and to correlate it with glucose disturbance and postsplenectomy status. Subjects and Methods. 50 thalassemic patients, in addition to 15 healthy controls. All patients underwent clinical assessment and laboratory investigations. Out of 50 thalassemic patients, 37 patients were splenectomized. MRI was performed for all subjects. Results. All patients showed significant reduction in the signal intensity of the liver and the pancreas on T2(∗)GRD compared to controls, thalassemic patients who had abnormal glucose tolerance; diabetic and impaired glucose tolerance patients displayed a higher degree of pancreatic and hepatic siderosis and more T2(∗) drop in their signal intensity than those with normal blood sugar level. Splenectomized thalassemic patients had significantly lower signal intensity of the liver and pancreas compared to nonsplenectomized patients. Conclusion. T2(∗) gradient echo MRI is noninvasive highly sensitive method in assessing hepatic and pancreatic iron overload in thalassemic patients, more evident in patients with abnormal glucose tolerance, and is accelerated in thalassemic splenectomized patients.
背景。MRI已成为用于各种组织中铁过载无创评估的方法。本文旨在通过T2(∗)加权梯度回波MRI评估重型β地中海贫血年轻患者的肝脏和胰腺铁过载情况，并将其与血糖紊乱及脾切除状态相关联。对象与方法。50例地中海贫血患者，另有15名健康对照者。所有患者均接受了临床评估和实验室检查。50例地中海贫血患者中，37例行脾切除术。对所有受试者进行了MRI检查。结果。与对照组相比，所有患者在T2(∗)梯度回波序列上肝脏和胰腺的信号强度均显著降低，地中海贫血患者中糖耐量异常者、糖尿病患者及糖耐量受损患者的胰腺和肝脏铁沉积程度更高，其信号强度的T2(∗)下降幅度比血糖水平正常者更大。与未行脾切除术的地中海贫血患者相比，行脾切除术的患者肝脏和胰腺的信号强度显著更低。结论。T2(∗)梯度回波MRI是评估地中海贫血患者肝脏和胰腺铁过载的一种无创且高度敏感的方法，在糖耐量异常患者中更为明显，在脾切除的地中海贫血患者中更为突出。
