Mandal Shantanu, Sodhi Kushaljit Singh, Bansal Deepak, Sinha Anindita, Bhatia Anmol, Trehan Amita, Khandelwal Niranjan
Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
Department of Pediatrics, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Pediatr. 2017 Apr;84(4):276-282. doi: 10.1007/s12098-017-2310-8. Epub 2017 Feb 24.
To evaluate Magnetic resonance imaging (MRI) as a tool to quantify liver and cardiac iron in Indian population with thalassemia major, and correlate liver and cardiac iron values with that of serum ferritin (SF).
Fifty patients aged between 8 to 18 y, with thalassemia major on regular blood transfusions and oral iron chelation therapy were enroled in the study. Twenty patients within the same age group, having no history of blood transfusions and no liver or cardiac disease were taken as controls. T2* MRI of heart and liver and SF estimation was done for all the cases as well as controls. All MRI scans were done on a 1.5-T Siemens MRI scanner using body coil.
The mean SF among cases was 2150 ng/ml (SD 2179). Significant correlation was found in patients between liver iron concentration (LIC, mean 15) and SF levels (r = 0.522; p < 0.001), and also significant but weaker correlation was found in patients between myocardial iron concentration (MIC, mean 1.3) and SF levels (r = 0.483; p < 0.001). Seventeen (34%) patients had a SF of <1000 ng/ml. Of these, 11 and 3 patients respectively had LIC and MIC more than normal range.
T2* MRI is a valuable non-invasive tool for quantification of liver and cardiac iron deposition in patients with thalassemia major. It can demonstrate high LIC and MIC, even though the targeted SF levels are low in thalassemia, indicating the need for escalation of the chelation therapy. This needs to be confirmed on full-fledged larger prospective studies.
评估磁共振成像（MRI）作为一种工具，用于量化印度重型地中海贫血患者肝脏和心脏的铁含量，并将肝脏和心脏的铁含量值与血清铁蛋白（SF）进行相关性分析。
本研究纳入了50例年龄在8至18岁之间、接受定期输血和口服铁螯合治疗的重型地中海贫血患者。选取20例年龄相同、无输血史且无肝脏或心脏疾病的患者作为对照。对所有病例和对照均进行了心脏和肝脏的T2* MRI检查以及SF测定。所有MRI扫描均使用体线圈在1.5-T西门子MRI扫描仪上进行。
病例组的平均SF为2150 ng/ml（标准差2179）。在患者中，肝脏铁浓度（LIC，平均值15）与SF水平之间存在显著相关性（r = 0.522；p < 0.001），并且在患者中心肌铁浓度（MIC，平均值1.3）与SF水平之间也存在显著但较弱的相关性（r = 0.483；p < 0.001）。17例（34%）患者的SF < 1000 ng/ml。其中，分别有11例和3例患者的LIC和MIC超过正常范围。
T2* MRI是一种用于量化重型地中海贫血患者肝脏和心脏铁沉积的有价值的非侵入性工具。即使在地中海贫血患者中目标SF水平较低，它也能显示出高LIC和MIC，这表明需要加强螯合治疗。这需要在全面的更大规模前瞻性研究中得到证实。
