Ning Xiaojing, Tan Siyu, Peng Fei, Luo Chaotian, Tang Cheng, Xiao Fangyan, Peng Peng
Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China; NHC Key Laboratory of Thalassemia Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.
Eur J Radiol. 2024 Dec;181:111750. doi: 10.1016/j.ejrad.2024.111750. Epub 2024 Oct 10.
To elucidate the iron load in different organs of non-transfusion-dependent thalassemia (NTDT) patients using magnetic resonance imaging (MRI) T2* scan.
Thirty-four NTDT patients, including 28 NTDT iron chelation without and 6 NTDT with iron chelation, together with 15 normal controls, underwent MRI examination between December 2022 and July 2024 were enrolled in the study. Measured T2* of the pituitary gland, kidney cortex, heart, liver, pancreas, spleen. Liver and spleen volumes were evaluated.
Of the 28 patients in NTDT without iron chelation group, 19 patients with iron overload in the liver, 9 patients with iron overload in the kidneys, and 4 patients with iron overload in the spleen. Most patients with abnormal kidney and spleen iron (76.9 %) had liver iron overload. Compared with the control group, NTDT without iron chelation patients had lower T2* in the liver, kidney, and spleen (p < 0.05). And heart T2* was correlated with kidney T2* (r = 0.480, p = 0.010) and pancreas (r = 0.411, p = 0.037). Liver T2* was correlated with spleen T2* (r = 0.479, p = 0.011). Pancreas T2* was correlated with pituitary T2* (r = -0.433, p = 0.031).
NTDT patients exhibit significant organ-specific iron overload, particularly in the liver, kidneys, and spleen. The correlations between iron levels in different organs suggest interconnected mechanisms of iron accumulation. These findings highlight the importance of regular MRI screening to monitor and manage iron overload in NTDT patients.
使用磁共振成像（MRI）T2*扫描阐明非输血依赖型地中海贫血（NTDT）患者不同器官中的铁负荷情况。
选取2022年12月至2024年7月间接受MRI检查的34例NTDT患者，其中28例未进行铁螯合治疗的NTDT患者和6例进行了铁螯合治疗的NTDT患者，以及15名正常对照者纳入研究。测量垂体、肾皮质、心脏、肝脏、胰腺、脾脏的T2*值。评估肝脏和脾脏体积。
在28例未进行铁螯合治疗的NTDT患者中，19例肝脏有铁过载，9例肾脏有铁过载，4例脾脏有铁过载。大多数肾脏和脾脏铁异常的患者（76.9%）有肝脏铁过载。与对照组相比，未进行铁螯合治疗的NTDT患者肝脏、肾脏和脾脏的T2值较低（p<0.05）。心脏T2值与肾脏T2值相关（r=0.480，p=0.010），与胰腺T2值相关（r=0.411，p=0.037）。肝脏T2值与脾脏T2值相关（r=0.479，p=0.011）。胰腺T2值与垂体T2值相关（r=-0.433，p=0.031）。
NTDT患者表现出明显的器官特异性铁过载，尤其是在肝脏、肾脏和脾脏。不同器官中铁水平之间的相关性表明铁积累存在相互关联的机制。这些发现凸显了定期进行MRI筛查以监测和管理NTDT患者铁过载的重要性。
