遺傳性血鐵沉積症於磁振造影之評估及生物檢測數據之相關性研究分析

The Evaluation with Magnetic Resonance Imaging and Correlation Analysis of Biomarker Data in Hereditary Hemochromatosis

目的：血鐵沉積症病患之鐵質沉積含量大都仰賴血液檢查，無法經由非侵入性方式量化體內單一器官之鐵質沉積量。本研究藉磁振造影對於體內單一器官之鐵質沉積量取得量化之評估功能及其相關性分析。方法：本回溯性研究收集三十二名病患之磁振影像資料，進行心肌及肝臟之鐵質沉積量與心臟功能性評估，同時與多項生物檢測數據進行相關性之統計分析。結果：結果顯示T2*肝臟和LIC(r=-0.647，p<0.001)及ferritin(r=-0.521，p<0.001)兩組在統計上呈現極顯著中度負相關性；LIC和ferritin(r=0.465，p<0.001)在統計上則呈現極顯著中度正相關性；BMD和LIC(r=0.333，p<0.001)及ferritin(r=0.248，p=0.017)也具有顯著相關性；至於T2*心肌和LIC(r=-0.207，p=0.047)的顯著負相關性。最後，血紅素和儲鐵蛋白為顯著相關(r=0.204，p=0.05)。結論：目前國內鮮少醫學中心或區域級醫療院所利用磁振造影技術針對血鐵沉積症患者評估體內單一器官之鐵質沉積量，希望我們的研究結果可提供臨床上診療之參考。

Objectives. The iron concentration determinations in vivo generally rely on biomarker; in addition, the iron deposition of single organ is nearly unable to be quantified via non-invasive method in clinical routine. Magnetic resonance imaging possesses the iron deposition amount quantification ability.
Methods. In this retrospective research, we are going to collect the magnetic resonance imaging data of thirty-two thalassaemia patients, and the amount of iron deposition in their heart and liver were evaluated. The functional assessment of heart and liver will also were performed as well as the correlation analysis with biomarker data.
Results. A highly negative correlation were observed on liver T2*/ferritin(r=-0.521, p<0.001) and liver T2*/LIC(r=-0.647, p<0.001), in addition, it existed highly positive correlation between LIC and ferritin(r=0.465, p<0.001). By the way, the results of LIC/BMD (r=0.333, p<0.001) and ferritin/BMD(r=0.248, p=0.017) were significant correlation. However, the result of heart T2*/ LIC(r=-0.207, p=0.047) indicated that LIC may serve as the reference for heart iron overload. Finally, the significant correlation between ferritin and hemoglobin (r=0.204, p=0.05).
Conclusion. There are rare medical center or local hospitals used magnetic resonance imaging technique to assess the content of iron deposition for single organ in vivo at present. We wish this research could benefit further clinical research strategy as well as the diaganosis and patient treatment.