Purpose
To introduce a new technique for the evaluation of myocardial iron overload in multi-transfused thalassemic patients by means of T2* quantitative Magnetic Resonance Imaging (T2*qMRI).
Methods and Materials
PatientsCardiac MR imaging studies of 20 thalassemic patients with beta-thalassemia major (mean 265.6, median age : 29.6 yrs ) were retrospectively reviewed. All patients received systematic red blood cell transfusions and subcutaneous chelation with desferroxamine. Total iron burden was assessed in all patients by means of Serum Ferritin Concentration levels (ng/ml). 10 normal subjects enrolled this study. MR imaging: Imaging techniqueAll MR imaging examinations were performed in a 1-year period, on a 1.5 T MR imaging system (Magnetom Vision Plus, Siemens). Body coil was used...
Results
Differences of myocardial mean T2*,R2* and T2*CR/MS values between patients and normal subjects were considered extremely significant (p<0.0001) (Fig.5), (Fig. 6). Differences of myocardial mean T2* and R2* were considered extremely significant when compared with either liver T2* and R2* (t=5.4, p<0.0001) or paraspinous muscle T2* and R2* (t=7.47, p<0.0001) (Fig. 7). Myocardial T2* was not correlated with SFC levels (r=0.39, p=0.10) (Fig.8). T2*CR/MS was poorely correlated with SFC (r=0.43, p=0.08) (Fig. 9).Three hemosiderotic patient cases with different iron depositionin their myocardium and liver are...
Conclusion
Myocardial iron deposition can be evaluated using either myocardial T2*, R2* or T2*CR/MS) measurements. Ferritin levels do not seem to serve as an accuratemeans for assesing iron overload in hemosiderotic patients.
References
(1) St Pierre TG. Deferiprone versus desferrioxamine in thalassaemia, and T2* validation and utility. Lancet. 2003 Jan 11;361(9352):182; author reply 183-4.(2) Dimopoulou I, Kremastinos DT, Maris TG, Mavrogeni S, Tzelepis GE. Respiratory function in patients with thalassaemia and iron overload. 7Eur Respir J. 1999 Mar;13(3):602-5.(3) Mavrogeni SI, Maris T, Gouliamos A, Vlahos L, Kremastinos DT. Myocardial iron deposition in beta-thalassemia studied by magnetic resonance imaging. Int J Card Imaging. 1998 Apr;14(2):117-22.(4) Nagel E, Underwood R, Penell D, Sechtem UP, Neubauer S, Wickline S, Hess OM,...
Personal Information
T.G. Maris1, O. Papakonstantinou2, M. Deimling3, Z. Spiridaki2, N. Papanikolaou2, S. Karampekios2, N. Gourtsoyiannis2.(1) Medical Physics Department, University Hospital of Heraklion, University of Crete, Heraklion/Crete.email :
[email protected](2) Radiology Department, University Hospital of Heraklion, University of Crete, Heraklion/Crete.(3) Magnetic Resonance (MREA), Siemens Medical Systems, Erlangen, Germany.