The magnetic resonance imaging findings in a hereditary hemochromatosis pedigree
-
摘要: 目的探讨一个遗传性血色病(HH)家系(A)及其旁系(B)的临床MRI特点。方法对A、B家系成员进行临床、生化、肝穿活检组织铁染色及多器官MRI检查。结果 (1)部分成员有血色病相关临床表现及异常生化指标;(2)3例患者接受肝活检,发现2例肝细胞内较多铁质沉积,另1例未见明显铁沉积;(3)MRI:部分成员心肝脾胰有不同程度的铁质沉积,表现为低信号影,肾脏、大脑均未见铁沉积。结论 (1)该血色病家系HH患者铁质主要沉积在肝脏,其他脏器如心脏、脾脏、胰腺亦有累及;而其旁系可见部分成员生化异常及脏器铁沉着,但尚未发现相关血色病临床表现,是否处于发病早期尚待随访观察;(2)与肝活检相比,MRI对组织铁沉积诊断较为准确。Abstract: Objective To describe the clinical and magnetic resonance imaging (MRI) features of a hereditary hemochromatosis (HH) pedigree (A) and its collateral (B) .Methods Clinical, biochemical, liver biopsy and MRI studies were carried out among the family members.Results (1) Some of the pedigree members showed hemochromatosis correlating symptom and physical sign.The biochemical values presented different abnormal elevation. (2) 3 patients received liver biopsy, of which 2 patients suffered from extensive hepatic hemosiderin deposition which was revealed after the Prussian blue iron stain, and 1 patient was quite normal. (3) Iron overload was found in some members of the pedigree, especially in the liver, pancreas, heart and the spleen by showing low signals on MRI, but no iron overload was observed in the brain and kidney.Conclusion (1) Iron overload was found primarily in the liver and then in the heart, spleen and pancreas of HH members of A portion of the pedigree;only some members of B portion were found having abnormal biochemical examination and iron overload in some organs, without any hemochromatosis correlating symptom and physical sign.Further follow up were needed to know if they were on the early stage of HH. (2) Compared with the liver biopsy, MRI is more accurate diagnostic tool for iron overload in tissues.
-
Key words:
- hemochromatosis /
- magnetic resonance imaging
-
[1]Franchini M.Hereditary iron overload:update on pathop-hysiology, diagnosis, and treatment[J].Am J Hematol, 2006, 81 (3) :202-209. [2]Brissot P, Troadec MB, Bardou-Jacquet E, et al.Currentapproach to hemochromatosis[J].Blood Rev, 2008, 22 (4) :195-210. [3]单渊东, 朱文玲, 张之南.我国22例血色病综合分析[J].中华内科杂志, 1990, 29 (3) :155-157. [4]秦恩强, 王凝芳, 赵敏, 等.39例原发性血色病临床特点分析[J].中华医学丛刊, 2003, 3 (9) :18-19. [5]张人玲, 邢维常, 张念察, 等.家族性血色病 (附同一家族4例报道) [J].中国糖尿病杂志, 1995, 3 (1) :18-21. [6]王强, 陈蕾, 吴杰.以多形红斑为首发表现的遗传性血色病二例[J].中华皮肤科杂志, 2005, 38 (3) :187-188. [7]Tavill AS, American Association for the Study of Liver Diseases, American College of Gastroenterology, et al.Diagnosis andmanagement of hemochromatosis[J].Hepatology, 2001, 33 (5) :1321-1328 [8]Tziomalos K, Perifanis V.Liver iron content determination bymagnetic resonance Imaging[J].World J Gastroenterol, 2010, 16 (13) :1587-1597. [9]沈俊松, 叶进, 江军.探讨Ⅳ型遗传性血色病肝脏hepcidin mRNA表达及意义[J].临床肝胆病杂志, 2008, 24 (6) :436-439. [10]沈俊松, 叶进, 江军.Ⅳ型遗传性血色病一例家系的临床研究[J].中华内科杂志, 2008, 47 (10) :840-841. [11]Thomas GM, Olympia P, Vasiliki C, et al.Myocardial and liver lronstatus using a fast T*2 quantitative MRI (T*2qMRI) technique[J].Magnetic Resonance in Medicine, 2007, 57 (4) :742-753.
本文二维码
计量
- 文章访问数: 3698
- HTML全文浏览量: 15
- PDF下载量: 1162
- 被引次数: 0