文章：

血液恶性肿瘤和慢性肝病的磁共振成像评价心脏和肝铁的关系

The relationship between cardiac and liver iron evaluated by MR imaging in haematological malignancies and chronic liver disease

原文发布日期：2012-01-13

DOI: 10.1038/bcj.2011.48

类型: Original Article

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英文摘要：

Although iron overload is clinically significant, only limited data have been published on iron overload in haematological diseases. We investigated cardiac and liver iron accumulation by magnetic resonance imaging (MRI) in a cohort of 87 subjects who did not receive chelation, including 59 haematological patients. M-HIC (MRI-based hepatic iron concentration, normal values <36 μmol/g) is a non-invasive, liver biopsy-calibrated method to analyse iron concentration. This method, calibrated to R2 (transverse relaxation rate), was used as a reference standard (M-HIC(R2)). Transfusions and ferritin were evaluated. Mean M-HIC(R2) and cardiac R* of all patients were 142 μmol/g (95% CI, 114–170) and 36.4 1/s (95% CI, 34.2–38.5), respectively. M-HIC(R2) was higher in haematological patients than in patients with chronic liver disease or normal controls (P<0.001). Clearly elevated cardiac R2* was found in two myelodysplastic syndrome (MDS) patients with severe liver iron overload. A poor correlation was found between liver and cardiac iron (n=82, r=0.322, P=0.003), in contrast to a stronger correlation in MDS (n=7, r=0.905, P=0.005). In addition to transfusions, MDS seemed to be an independent factor in iron accumulation. In conclusion, the risk for cardiac iron overload in haematological diseases other than MDS is very low, despite the frequently found liver iron overload.

摘要翻译： 

尽管铁过载在临床上具有重要意义，但关于血液疾病中铁过载的已发表数据仍然有限。我们通过磁共振成像（MRI）在一组未接受螯合治疗的87名受试者中研究了心脏和肝脏铁的积聚，其中包括59名血液病患者。M-HIC（基于MRI的肝脏铁浓度，正常值<36 μmol/g）是一种无创、经肝活检校准的方法，用于分析铁浓度。该方法经R2（横向弛豫率）校准，被用作参考标准（M-HIC(R2)）。同时对输血和铁蛋白进行了评估。所有患者的平均M-HIC(R2)和心脏R*分别为142 μmol/g（95% CI，114–170）和36.4 1/s（95% CI，34.2–38.5）。血液病患者的M-HIC(R2)高于慢性肝病患者或正常对照组（P<0.001）。在两例伴有严重肝脏铁过载的骨髓增生异常综合征（MDS）患者中发现心脏R2*明显升高。肝脏铁与心脏铁之间的相关性较差（n=82，r=0.322，P=0.003），而在MDS中相关性较强（n=7，r=0.905，P=0.005）。除输血外，MDS似乎是铁积聚的一个独立因素。总之，除MDS以外的血液病患者发生心脏铁过载的风险非常低，尽管常可见肝脏铁过载。

原文链接：

The relationship between cardiac and liver iron evaluated by MR imaging in haematological malignancies and chronic liver disease