Femoral head avascular necrosis in sickle cell anemia: MR characteristics

Since considerable expansion of hematopoietic marrow occurs in patients with sickle cell anemia (SCA), magnetic resonance images of 20 hips in 10 patients with known homozygous SCA were reviewed to determine a) if low signal hematopoietic marrow extended into the femoral capital epiphysis and b) if the MR characteristics of avascular necrosis (AVN) differed depending on the type of epiphyseal marrow. Our results revealed variable epiphyseal marrow type; mixed (fatty and hematopoietic) marrow (42%), fatty marrow (32%), hematopoietic marrow (16%) and hemosiderotic marrow (10%). AVN occurred irrespective of the underlying marrow. Segmental areas of low signal intensity in variable shapes (ring, band, crescent or large homogeneous area) was the most consistent MR manifestation of AVN in SCA. A low signal intensity peripheral rim surrounding a central zone, isointense with epiphyseal marrow on T₁ and T₂ weighted images, was most frequently observed similar to that described in patients without hemoglobinopathy. The notable difference, however, was of segmental areas within the same femoral head that demonstrated variable central zone signal on T₂ weighted images. Further, while an increase in hip joint fluid is commonly seen with both early and advanced AVN in patients without hemoglobinopathy; it was increased in only one hip in patients with SCA. The observed differences in MR characteristics may be due to different pathophysiology of AVN in patients with SCA.     

拉曼光谱在血红蛋白结构及功能研究中的应用进展

血红蛋白发挥多种重要生理功能,但对其结构及功能的认识尚不能满足疾病诊治的需求。拉曼光谱在血红蛋白结构及功能研究中具有很大应用潜力,不但可以检测血红蛋白中血红素及其周围分子结构变化,还可以反映血红蛋白反应动力学具体过程。同时,血红蛋白拉曼光谱在疾病状态下异常血红蛋白检测,血氧饱和度定量测定及血液代用品的高铁血红蛋白含量检测中突显优势。本文综述了拉曼光谱在血红蛋白结构及功能领域中的研究,简述了拉曼光谱在一些病变血红蛋白诊断中的研究进展,分析了影响血红蛋白拉曼光谱检测的因素,以促进拉曼光谱技术在血红蛋白结构和功能研究中的应用。