Magnetic resonance imaging in the evaluation of iron overload in patients with beta thalassaemia and sickle cell disease

Br J Haematol. 2004 Sep;126(5):736-42. doi: 10.1111/j.1365-2141.2004.05104.x.

Abstract

Magnetic resonance imaging (MRI) appears to be useful for monitoring iron overload in thalassaemia. We studied 106 patients with beta-thalassaemia: 80 with thalassaemia major (TM) and 26 with thalassaemia intermedia (TI). Thirty-five patients with sickle cell disease (SCD) were also evaluated. Serum ferritin, liver and myocardial T2-relaxation time and liver iron concentration (LIC) were measured. LIC values, based on biopsies from 29 patients, showed a close inverse correlation with the respective liver T2-values, along with a strong positive correlation with ferritin levels in all patients. Heart T2-values correlated with left ventricular ejection fraction in TM and SCD, but not in TI patients. Both liver and heart T2-values were significantly lower in TM patients than those of TI, and SCD patients. Ferritin levels showed a strong correlation with liver T2-values in all three groups of patients. Similarly, a negative correlation was found between serum ferritin levels and heart T2-values in TM, but not in TI and SCD patients. Heart and liver T2-values showed a significant correlation only in TM patients. These results suggest that the MRI technique (T2 relaxation time) used in our study, is a reliable, safe and non-invasive method for the assessment of the deposition of iron in the liver; results for the heart become reliable only when there is heavy iron deposition.

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Anemia, Sickle Cell / blood
  • Anemia, Sickle Cell / complications*
  • Anemia, Sickle Cell / therapy
  • Female
  • Ferritins / blood
  • Humans
  • Iron / metabolism*
  • Iron Overload / blood
  • Iron Overload / diagnosis*
  • Iron Overload / etiology
  • Liver / metabolism*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Myocardium / metabolism
  • Statistics, Nonparametric
  • Transfusion Reaction
  • beta-Thalassemia / blood
  • beta-Thalassemia / complications*
  • beta-Thalassemia / therapy

Substances

  • Ferritins
  • Iron