采用定量磁敏感图测量肝硬化患者脑深部灰质铁含量：与苍白球 T1 高信号的关系。
Deep gray matter iron measurement in patients with liver cirrhosis using quantitative susceptibility mapping: Relationship with pallidal T hyperintensity.
机构信息
Department of Radiology, Seoul St. Mary's Hospital, School of Medicine, Catholic University of Korea, Seoul, Korea.
Department of Surgery, Seoul St. Mary's Hospital, School of Medicine, Catholic University of Korea, Seoul, Korea.
出版信息
J Magn Reson Imaging. 2018 May;47(5):1342-1349. doi: 10.1002/jmri.25841. Epub 2017 Aug 17.
BACKGROUND
The liver is a central organ for the metabolism of iron and manganese and the places where those metals are commonly deposited overlap in the brain.
PURPOSE/HYPOTHESIS: To elucidate the relationship between pallidal T hyperintensity and iron deposition in the deep gray matter of liver cirrhosis patients using quantitative susceptibility mapping (QSM).
STUDY TYPE
Retrospective case-control study SUBJECTS: In all, 38 consecutive liver cirrhosis patients who received brain magnetic resonance imaging (MRI) as pretransplant evaluation.
FIELD STRENGTH/SEQUENCE: QSM was reconstructed from 3D multi- or single-echo phase images at 3T. T -weighted images were used for the assessment of pallidal hyperintensity and pallidal index (PI).
ASSESSMENT
Patients were divided into two groups according to the presence of pallidal hyperintensity by consensus of two radiologists. Susceptibility values were acquired for five deep gray matter structures.
STATISTICAL TEST
QSM measures were compared between two groups using the t-test. We also calculated Pearson correlations between QSM measures and PI.
RESULTS
In all, 26 patients showed pallidal hyperintensity (T h group) and 12 did not (T n group). The susceptibility of the globus pallidus (GP) in the T h group (120.6 ± 38.1 ppb) was significantly lower than that in the T n group (150.0 ± 35.2, P = 0.030). The susceptibility of the dentate nucleus (DN) in the T h group (88.1 ± 31.0) was significantly lower than that in the T n group (125.6 ± 30.6, P = 0.001). Negative correlation between the susceptibility of GP (r = -0.37, P = 0.022) and the PI, and between DN (r = -0.43, P < 0.001) and the PI was found.
DATA CONCLUSION
Liver cirrhosis patients with pallidal T hyperintensity had lower susceptibility values in the GP and DN than those without it. This suggests a possible interaction between iron and manganese in the brains of liver cirrhosis patients.
LEVEL OF EVIDENCE
3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1342-1349.
背景
肝脏是铁和锰代谢的中心器官，这些金属在大脑中的沉积部位重叠。
目的/假设：使用定量磁化率映射（QSM）阐明肝硬化患者深部灰质中铁沉积与苍白球 T 高信号之间的关系。
研究类型
回顾性病例对照研究
受试者
所有，38 例连续接受脑磁共振成像（MRI）作为移植前评估的肝硬化患者。
磁场强度/序列：在 3T 时从 3D 多回或单回相位图像重建 QSM。T 加权图像用于评估苍白球高信号和苍白球指数（PI）。
评估
根据两位放射科医生的共识，将患者分为两组，存在苍白球高信号的为 T h 组，不存在苍白球高信号的为 T n 组。为五个深部灰质结构采集磁化率值。
统计检验
使用 t 检验比较两组之间的 QSM 测量值。我们还计算了 QSM 测量值与 PI 之间的 Pearson 相关性。
结果
共有 26 例患者出现苍白球高信号（T h 组），12 例患者无苍白球高信号（T n 组）。T h 组苍白球（GP）的磁化率（120.6±38.1 ppb）明显低于 T n 组（150.0±35.2，P=0.030）。T h 组齿状核（DN）的磁化率（88.1±31.0）明显低于 T n 组（125.6±30.6，P=0.001）。发现 GP（r=-0.37，P=0.022）和 PI 之间以及 DN（r=-0.43，P<0.001）和 PI 之间存在负相关。
数据结论
苍白球 T 高信号的肝硬化患者 GP 和 DN 的磁化率值低于无苍白球 T 高信号的患者。这表明肝硬化患者大脑中铁和锰之间可能存在相互作用。
证据水平
3 级技术功效：第 3 阶段 J. Magn. Reson. Imaging 2018;47:1342-1349.
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