Siegelman E S, Outwater E, Hanau C A, Ballas S K, Steiner R M, Rao V M, Mitchell D G
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA.
J Comput Assist Tomogr. 1994 Jan-Feb;18(1):63-7. doi: 10.1097/00004728-199401000-00014.
Our goal was to determine the difference in iron distribution between transfusion dependent (TD) and nontransfusion dependent (NT) patients with sickle cell disease (SCD).
The T2-weighted and T2*-weighted abdominal MR images in nine cases of homozygous SCD were reviewed to determine the distribution of low signal from iron in five TD and four NT patients.
All eight patients with visualized spleens had decreased splenic signal intensity. One patient who had no history of splenectomy had no visualized splenic tissue. The majority of both groups had renal cortex of low signal intensity that was attributable to iron deposition from intravascular hemolysis and was not correlated with clinical renal abnormalities. None of the NT group had liver or pancreas of low signal intensity, while all five TD patients had decreased liver signal intensity and three of five had decreased pancreatic signal intensity.
Decreased pancreatic signal intensity can occur in TD patients, perhaps suggesting total body iron overload. Nontransfusion dependent sickle cell patients usually have normal hepatic signal intensity and do not have total body iron overload, even in the presence of renal and splenic iron deposition.
我们的目标是确定输血依赖型（TD）和非输血依赖型（NT）镰状细胞病（SCD）患者之间铁分布的差异。
回顾了9例纯合子SCD患者的腹部T2加权和T2*加权磁共振图像，以确定5例TD患者和4例NT患者中铁低信号的分布情况。
所有8例脾脏可见的患者脾脏信号强度均降低。1例无脾切除术病史的患者未见到脾脏组织。两组中的大多数患者肾皮质信号强度降低，这归因于血管内溶血导致的铁沉积，且与临床肾脏异常无关。NT组中无一例患者肝脏或胰腺信号强度降低，而所有5例TD患者肝脏信号强度降低，5例中有3例胰腺信号强度降低。
TD患者可能出现胰腺信号强度降低，这或许提示全身铁过载。非输血依赖型镰状细胞病患者通常肝脏信号强度正常，即使存在肾脏和脾脏铁沉积，也不存在全身铁过载。
