应用磁敏感加权成像评价肝硬化患者肝脏铁沉积及其与血清铁蛋白含量的相关性

目的 应用磁敏感加权成像( SWI)定量测量肝硬化患者肝脏相位像值,并分析其与血清铁蛋白含量的相关性.资料与方法 32例健康人和42例经临床诊断的乙型肝炎后肝硬化和酒精性肝硬化患者行SWI序列扫描,并检测血清铁蛋白浓度.应用SPIN软件测量健康人肝脏SWI相位值(SPU),将均值减2倍标准差作为相位像测量基线,以此基线为阈值将肝硬化患者相位像感兴趣区划分为高、低含铁区,测量高含铁区SPU,采用相关分析评价其与血清铁蛋白浓度的相关性.结果 32例健康人相位值为(2003±15) SPU,将1973SPU设为阈值对肝硬化患者SWI相位像感兴趣区内高含铁区进行测量,相位值(弧度)=-(0.273±0.142),血清铁蛋白浓度为(165.5±104.4) ng/ml,SWI相位像值与血清铁蛋白浓度呈负相关(r=-0.712,P＜0.001).结论 通过建立肝脏相位像测量基线可以评估肝硬化患者肝脏铁含量.

Assessment of Liver Iron Overload Using Susceptibility-weighted Imaging in Patients with Hepatic Cirrhosis: Correlation with Level of Serum Ferritin

Purpose To determine Siemens Phase Unit (SPU) of patients with hepatic cirrhosis by using MR susceptibility-weighted imaging (SWI), and to analyze its relationship with concentration of serum ferritin. Materials and Methods Thirty-two healthy individuals and 42 patients diagnosed with hepatic cirrhosis after chronic type B hepatitis and alcoholic cirrhosis underwent SWI. The serum ferritin of patients was also detected. The signal processing in NMR (SPIN) software was used to measure the SPU on SWI phase images in healthy individuals. Mean minus two times standard deviation of SPU was designated as a baseline, which was used as a threshold to classify the regions of interest (ROI) into high and low iron areas in the cirrhotic patients, then the SPU of high iron area was calculated. The relationship between SPU in high iron area and serum ferritin concentrations was analyzed. Results The phase value of 32 healthy participants was (2003±15) SPU; and the 1973 SPU was designated as the threshold. SPU of high-iron areas within ROI in cirrhosis patients was - (0.273±0.142). The serum ferritin concentration of cirrhosis patients was (165.5±104.4) ng/ml. Phase value was significant negative correlated with serum ferritin concentrations (r =- 0.712, P < 0.001). Conclusion SWI phase shift value can be used to noninvasively assess the iron deposition in hepatic cirrhosis patients after establishing the baseline on SWI phase image.