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伊朗西北部输血依赖型血红蛋白病的心脏和肝脏T2*加权磁共振成像

Cardiac and Hepatic T2*-Weighted Magnetic Resonance Imaging in Transfusion Dependent Hemoglobinopathy in North West of Iran.

作者信息

Valizadeh N, Alinejad V, Hejazi S, Noroozi M, Hashemi A, Rahimi B, Nateghi Sh

机构信息

Assistant professor of Hematology/Medical Oncology, Urmia University of Medical Sciences, Urmia, Iran.

MSc of of Biostatistics, Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran.

出版信息

Iran J Ped Hematol Oncol. 2015;5(4):206-10. Epub 2015 Dec 10.

Abstract

BACKGROUND

Iron overload is the main transfusion related side effects in patients with transfusion dependent hemoglobinopathies. Severe iron deposition in tissues leads to organ dysfunction. Many organs can be affected such as heart, liver, and endocrine organs. Cardiac failure and liver fibrosis are the consequent of Iron overload in transfusion dependent hemoglobinopathy. Magnetic Resonance Imaging (MRI) is a safe, noninvasive, and accurate method for the assessment of iron deposition in different tissues. This study assessed iron levels in liver and heart of the patients with transfusion dependent hemoglobinopathies.

MATERIALS AND METHODS

The studied population consisted of 12 patients (7 male and 5 female) with transfusion dependent hemoglobinopathies, aged between 10-18 years old. Then, Cardiac and liver T2*- weighted magnetic resonance imaging (MRI) were obtained.

RESULTS

In current study, 1patient (8.33%) had severe, 2 patients (16.66%) had moderate and 2(16.66%) had mild cardiac iron deposition. Out of 12 patients, 1 had severe iron deposition in liver (8.33%), 5(41.66%) and 4(33.33%) had moderate and mild hepatic iron deposition, respectively. Differences between Hepatic and cardiac iron levels were not significant between males and females (p>0.05).

CONCLUSION

Since cardiac and liver iron levels were higher than normal in most of the study group, checking ferritin level and liver function test and also echocardiography in shorter intervals (each 3 months) in involved group is suggested instead of checking routinely in 6 month intervals in patients with transfusion dependent hemoglobinopathies.

摘要

背景

铁过载是依赖输血的血红蛋白病患者主要的输血相关副作用。组织中严重的铁沉积会导致器官功能障碍。许多器官都可能受到影响,如心脏、肝脏和内分泌器官。心力衰竭和肝纤维化是依赖输血的血红蛋白病中铁过载的后果。磁共振成像(MRI)是一种安全、无创且准确的评估不同组织中铁沉积的方法。本研究评估了依赖输血的血红蛋白病患者肝脏和心脏中的铁水平。

材料与方法

研究人群包括12例年龄在10 - 18岁之间依赖输血的血红蛋白病患者(7例男性和5例女性)。然后,进行心脏和肝脏的T2*加权磁共振成像(MRI)检查。

结果

在本研究中,1例患者(8.33%)有严重心脏铁沉积,2例患者(16.66%)有中度心脏铁沉积,2例患者(16.66%)有轻度心脏铁沉积。在12例患者中,1例肝脏有严重铁沉积(8.33%),5例(41.66%)和4例(33.33%)分别有中度和轻度肝脏铁沉积。男性和女性的肝脏与心脏铁水平差异无统计学意义(p>0.05)。

结论

由于研究组中的大多数患者心脏和肝脏铁水平高于正常,建议对依赖输血的血红蛋白病患者缩短检查间隔时间(每3个月)检查铁蛋白水平、肝功能测试以及超声心动图,而不是每6个月进行常规检查。

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Zhonghua Xue Ye Xue Za Zhi. 2015 Apr;36(4):302-6. doi: 10.3760/cma.j.issn.0253-2727.2015.04.009.

本文引用的文献

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MRI of cardiac iron overload.心脏铁过载的 MRI 表现。
J Magn Reson Imaging. 2012 Nov;36(5):1052-9. doi: 10.1002/jmri.23628.
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Cardiovascular MRI in thalassemia major.地中海贫血症的心血管磁共振成像。
Ann N Y Acad Sci. 2010 Aug;1202:173-9. doi: 10.1111/j.1749-6632.2010.05571.x.
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Liver iron content determination by magnetic resonance imaging.磁共振成像测定肝脏铁含量。
World J Gastroenterol. 2010 Apr 7;16(13):1587-97. doi: 10.3748/wjg.v16.i13.1587.

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