Çetinçakmak Mehmet Güli, Hattapoğlu Salih, Söker Murat, Ekici Faysal, Yilmaz Kamil, Göya Cemil, Hamidi Cihad
Department of Radiology, Medical School, Dicle University, Diyarbakir, Turkey.
Department of Pediatrics, Medical School, Dicle University, Diyarbakir, Turkey.
Adv Clin Exp Med. 2020 Apr;29(4):475-480. doi: 10.17219/acem/116758.
Splenic iron overload is the most common clinical condition in patients with thalassemia. However, few studies of the effects of splenectomy have been published.
To evaluate the relationship between splenic iron overload and liver, heart and muscle features visible in T2*-weighted magnetic resonance imaging, and to investigate the effects of splenectomy on these tissues in patients with beta-thalassemia major (TM).
We retrospectively included 131 patients (76 male and 55 female) diagnosed with TM. All radiological assessments were performed with the aid of a Philips Achieva 1.5T scanner running a multiecho gradient-echo sequence. Hepatic and splenic T2* values were assessed in the same gradient multiecho series. Muscle T2* values were assessed in the shoulder girdle muscles adjacent to the heart area. The relationships among splenic T2*, hepatic T2*, cardiac T2* and muscle T2* parameters, serum ferritin levels, age and other parameters were evaluated.
The splenic T2* value correlated with serum ferritin level and the hepatic T2* value (p < 0.001 and p < 0.001, respectively). The splenic T2* value did not correlate with age, cardiac or muscle T2* values, or with spleen size (p = 0.27, 0.21, 0.99, and 0.39, respectively). The muscle T2* value correlated weakly with the serum ferritin level (p = 0.022). The cardiac T2* value was lower and the liver size greater in patients who had undergone splenectomy compared with those who had not (p < 0.001 and 0.001, respectively).
Splenic iron overload correlated with hepatic overload and the serum ferritin level. Splenectomy increased cardiac iron overload and triggered liver enlargement. However, the muscle iron overload was low and the muscles were therefore unaffected by splenectomy.
脾铁过载是地中海贫血患者最常见的临床病症。然而，关于脾切除术效果的研究发表较少。
评估脾铁过载与T2*加权磁共振成像中可见的肝脏、心脏和肌肉特征之间的关系，并研究脾切除术对重型β地中海贫血（TM）患者这些组织的影响。
我们回顾性纳入了131例诊断为TM的患者（76例男性和55例女性）。所有放射学评估均借助运行多回波梯度回波序列的飞利浦Achieva 1.5T扫描仪进行。在相同的梯度多回波序列中评估肝脏和脾脏的T2值。在心脏区域附近的肩胛带肌肉中评估肌肉T2值。评估脾脏T2*、肝脏T2*、心脏T2和肌肉T2参数、血清铁蛋白水平、年龄及其他参数之间的关系。
脾脏T2值与血清铁蛋白水平及肝脏T2值相关（分别为p < 0.001和p < 0.001）。脾脏T2值与年龄、心脏或肌肉T2值以及脾脏大小均无相关性（分别为p = 0.27、0.21、0.99和0.39）。肌肉T2值与血清铁蛋白水平呈弱相关（p = 0.022）。与未进行脾切除术的患者相比，进行脾切除术的患者心脏T2值较低，肝脏体积较大（分别为p < 0.001和0.001）。
脾铁过载与肝脏过载及血清铁蛋白水平相关。脾切除术增加了心脏铁过载并引发肝脏肿大。然而，肌肉铁过载较低，因此肌肉未受脾切除术影响。
