Multislice multiecho T2* cardiovascular magnetic resonance for detection of the heterogeneous distribution of myocardial iron overload

J Magn Reson Imaging. 2006 May;23(5):662-8. doi: 10.1002/jmri.20566.


Purpose: To assess the tissue iron concentration of the left ventricle (LV) using a multislice, multiecho T2* MR technique and a segmental analysis.

Materials and methods: T2* multiecho MRI was performed in 53 thalassemia major patients. Three short-axis views of the LV were obtained and analyzed with custom-written software. The myocardium was automatically segmented into 12 segments. The T2* value on each segment as well as the global T2* value were calculated. Cine dynamic images were also obtained to evaluate biventricular function parameters by quantitative analysis.

Results: For the T2* global value, the coefficient of variation (CoV) for intra-/interobserver and interstudy reproducibility was 3.9% (r = 0.98), 5.5% (r = 0.98), and 4.7% (r = 0.99) respectively. Three groups were identified based on analysis of myocardial T2*: homogeneous (21%), heterogeneous (38%), and no myocardial iron overload (41%). The mean serum ferritin, liver iron concentration, and urinary iron excretion were significantly different among the groups. We did not find significant differences among groups in biventricular function. There was a correlation between the global T2* value and the T2* value in the mid-ventricular septum (r = 0.95, P < 0.0001).

Conclusion: Multislice multiecho T2* MRI provides a noninvasive, fast, reproducible means of assessing myocardial iron distribution. The single measurement of mid-septal T2* correlated well with the global T2* value.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Ferritins / blood
  • Heart Ventricles / metabolism
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Iron / metabolism
  • Iron / urine
  • Iron Overload / diagnosis*
  • Iron Overload / metabolism
  • Liver / metabolism
  • Magnetic Resonance Imaging / methods*
  • Magnetic Resonance Imaging, Cine
  • Male
  • Middle Aged
  • Myocardium / metabolism
  • Myocardium / pathology*
  • Observer Variation
  • Reproducibility of Results
  • beta-Thalassemia / complications


  • Ferritins
  • Iron