Imaging Department, CHU de Poitiers, 2 Rue de la milétrie, 86000 CHU de Poitiers, France.
Hepatology Department, CHU de Poitiers, 2 Rue de la milétrie, 86000 CHU de Poitiers, France.
Eur J Radiol. 2019 Jul;116:47-54. doi: 10.1016/j.ejrad.2018.02.011. Epub 2018 Feb 12.
To measure hepatic iron concentration (HIC) heterogeneities using a magnetic resonance R2* mapping method.
Ninety-four patients with suspected hepatic iron overload and 10 volunteers were included prospectively. A multi-echo R2* sequence with fat saturation and with three post-processing fitting methods (a single exponential decay model with or without truncation, SED and SEDt, and a constant offset model, COS) was compared to a signal intensity ratio method (SIR), considered as the reference. HIC heterogeneity was evaluated from R2* mapping after placing a ROI on each liver segment.
A strong linear correlation between SIR and R2* methods using the SEDt and COS models was observed (r = 0.973 and 0.955, respectively). Volunteers and patient liver variabilities, quantified by mean intra-liver standard deviation (SD) were 1.58 μmol/g (mean range 5.06 μmol/g) and 4.73 μmol/g (mean range 19.08 μmol/g), respectively. For the patient group, the highest HIC was observed in the IV segment. Heterogeneity increased for patients with an HIC > 60 μmol/g (mean intra-liver SD = 13.90 μmol/g; mean range = 50.60 μmol/g).
This study is the first to demonstrate in vivo HIC heterogeneities using whole-liver mapping analysis. These preliminary results require confirmation through further studies, but might be useful in cases of single ROI analysis.
使用磁共振 R2* 映射方法测量肝铁浓度(HIC)异质性。
前瞻性纳入 94 例疑似肝铁过载患者和 10 名志愿者。多回波 R2* 序列采用脂肪饱和,三种后处理拟合方法(带或不带截断的单指数衰减模型,SED 和 SEDt,以及常数偏移模型,COS)与信号强度比方法(SIR)进行比较,后者被视为参考。通过在每个肝段放置 ROI 从 R2* 映射评估 HIC 异质性。
SEDt 和 COS 模型的 SIR 和 R2* 方法之间存在很强的线性相关性(r=0.973 和 0.955)。志愿者和患者肝脏变异性由肝内平均标准偏差(SD)定量,分别为 1.58μmol/g(平均范围 5.06μmol/g)和 4.73μmol/g(平均范围 19.08μmol/g)。对于患者组,IV 段的 HIC 最高。HIC>60μmol/g 的患者(肝内平均 SD=13.90μmol/g;平均范围=50.60μmol/g)的异质性增加。
本研究首次在体研究使用全肝映射分析显示 HIC 异质性。这些初步结果需要通过进一步研究来证实,但在单个 ROI 分析的情况下可能有用。