MRI Assessment of Liver and Cardiac Iron Concentrations in Some Patients with Beta Thalassemia Major
Iraqi Postgraduate Medical Journal,
2018, Volume 17, Issue 1, Pages 82-90
Iron overload is a major concern in blood transfusion dependent beta-thalassemic patient and it is a major cause of cardiac dysfunction. Magnetic resonance imaging T2* has a vital role in liver and cardiac iron deposition and assessment of its severity
To highlight the role of MRI T2* in assessment of liver and cardiac iron deposition and assessment of other methods of liver and cardiac iron concentration estimation.
PATIENTS AND METHODS:
This cross sectional prospective study had been conducted at the MRI unit of Al-Imamain AL-Khadimain medical city, Baghdad/ Iraq, from December 2015 to December 2016. One hundred, blood transfusion dependent beta-thalassemia major patients had been examined by MRI using T2* images to assess its value which had been changed to liver iron concentration and cardiac iron concentration by using a MEDIS software program.
One hundred patients (56 male and 44 female) of transfusion dependent beta-thalassemia major had been evaluated for their liver and cardiac T2*, 17 of them shows a mild LIC (liver iron concentration) and normal MIC (myocardial iron concentration), 49 patients show mild increase in both LIC and MIC, 9 show moderate LIC and mild MIC, 16 show moderate both LIC and MIC, 2 show severe LIC with mild MIC, only one shows severe LIC with moderate MIC and 6 of them show severe both LIC and MIC. There is a positive significant correlation between liver T2* and cardiac T2* (P values of 0.017), between liver T2* and LIC (P value of > 0.001), between liver T2* and MIC (P value of 0.031) and that between cardiac T2* and MIC (P value is >0.001). There is non- significant correlation between the age and frequency of blood transfusion with LIC and MIC (P value <0.05). There is also a significant negative correlation between S.ferritin and liver T2*and cardiac T2* (correlation coefficient of -0.251 and -0.397 respectively), with a (P value of 0.014 and 0.00015 respectively). There is non significant correlation between S. ferritin and the severity of LIC and MIC (P value of 0.129 and 0.792).
Magnetic resonance imaging has a vital role as a non-invasive and reliable method in the assessment of liver and cardiac iron deposition in patients with blood transfusion dependent beta-thalassemia major. There is no correlation between S.ferritin level and the severity of LIC and MIC. Patients using Exjade show a lower LIC and MIC than those using Desferal. No correlation between age and frequency of blood transfusion with LIC and MIC in patients on regular chelation.
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