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1、医学影像学杂志2010年第20卷第7期JMedImagingVol.20No.72010血色素沉着症的MRI诊断郭学军,王成林,刘鹏程,石桥,向先俊,单慧明(北京大学深圳医院影像中心广东深圳518036)摘要目的:探讨血色素沉着症的MRI表现,分析其MRI特征,对病变组织的铁质沉积作初步定量分析,同时评价MRI在血色素沉着症的诊断中的价值。方法:对19例血色素沉着症患者及20例对照组测量其T2WI上肝、脾及竖脊肌的信号强度,分别计算肝脏、脾脏与竖脊肌的信号强度比值,计算其信号比值下降程度。结果:19例血色素沉着症病例中,MRI检查在各种不同序列中均可见不
2、同程度组织信号强度减低,T1WI和T2WI亦都可显示组织信号减低,以T2WI显示更为明显,其中以GRE序列尤为敏感。19例中,肝、脾信号都明显减低者6例,单纯肝脏信号减低者8例,5例脾脏信号减低而肝脏信号减低不明显,未见1例胰腺信号明显减低病例。结论:MRI对血色素沉着症的诊断具有高度的敏感性和特异性,结合实验室检查,可取代组织活检的金标准地位,对血色素沉着症的早期诊断和早期治疗具有重要的临床意义。关键词血色素沉着症;磁共振成像中图分类号:R596;R445.2文献标识码:A文章编号:1006-9011(2010)07-1034-04MRIdiagnos
3、isofhemochromatosisGUOXuejun,WANGChenlin,LIUPengcheng,SHIQiao,XIANGXianjun,SHANHuimingDepartmentofRadiology,PekingUniversityShenzhenHospital,Shenzhen518036,P.R.ChinaAbstractObjective:ToinvestigateMRImanifestationsandcharacteristicsofhemochromatosis,tomakeapreliminaryquantitativeanal
4、ysisofthelevelofreducedsignal,aswellastoevaluatethevalueofMRIindiagnosisofhemochromatosis.Methods:Thesignalintensitiesofliver,spleenandspinalmuscularerectionweremeasuredon19caseswithhemochromatosisand20casesincontrolgroup,andthesignalintensityratioandthelevelofreducedsignalratiowerecalcula
5、tedseparately.Results:Of19caseswithhemochromatosis,eachofdifferentMRIsequencescoulddisplayreducedsignalintensityofvaryingseverityinliverandspleen.T1WIandT2WIalsoshowedreducedsignalintensityofliverandspleen,obviouslyonT2WI,andmoresensitiveespeciallyonGREsequence.Of19cases,thesignalintensityr
6、educedobviouslyin6casesbothinliverandspleen,8casesonlyinliver,5casesinspleenbutnoobviouslyinliver,nocasesinpancreas.Conclusion:MRIhasahighdegreeofsensitivityandspecificityforthediagnosisofhemochromatosis.Bycombiningwithlaboratorytests,MRIcanreplacethegoldstandardstatusofbiopsy.Ithasveryi
7、mportantclinicalsignificanceforearlydiagnosisandtreatmentofhemochromatosis.KeywordsHemochromatosis;Magneticresonanceimaging血色素沉着症是由于铁质过多沉积在人体组织性12例,女性7例,年龄17~81岁,平均年龄46.3内所致。MRI对血色素沉着症的诊断有较高的敏感岁。19例中,仅有1例为MRI检查前即有明确血色性和特异性,但国内目前有关本病的系统报道不多。素沉着症病史复查病
