Keywords:
Connective tissue disorders, Imaging sequences, Diagnostic procedure, MR, Cardiac
Authors:
R. T. M. Khafagy1, A. El Sayed1, S. Khalil1, B. M. R. M. A. Habib1, G. Samir1, D. F. Haroun1, S. W. Tantawy1, F. R. M. Elkafrawy2, S. nabil1, A. elMogy1, A. salama1, M. Shaaban3, A. S. Ibrahim1; 1Cairo/EG, 2Alexandria, Alexandria/EG, 3Aswan/EG
Methods and Materials
With institutional review board approval and informed consent, a prospective pilot study was conducted including 20 patients with SCD (median age 13.5 years, range 7-21 years old).
Inclusion criteria included patients with SCD receiving regular blood transfusions, treatment with iron chelation therapy, and referral for cardiac MRI assessment of cardiomyopathic changes and myocardial iron overload. Only cases with normal cardiac iron overload were included. Hematocrit level was measured for each patient within 24 hours prior to the MRI examination.
Patients with any of the following conditions were excluded from the study: myocardial siderosis(n=2) ,claustrophobia(n =1), impaired renal function(n= 1) or any general MRI contraindication.
Cardiac MRI at 1.5T included short axis cine steady-state free-precession images, for left ventricular function assessment, and T2* images using a cardiac-gated segmented multi-gradient-echo (MGE) sequence, with 8 equally spaced echoes, 2.5 ms apart, for myocardial iron assessment. Mid septal T2* values were calculated for each patient.
Assessment of myocardial fibrosis was performed using late gadolinium-based contrast material enhancement (LGE) and modified Look-Locker inversion recovery (MOLLI)–based T1mapping. MOLLI sequence was performed before and 10 minutes after administration of 0.3 mmol of gadolinium-based contrast per kilogram of body weight. Mid septal T1 values were calculated for each patient.