Clinical Value of MRI T2* in Assessment of Myocardial, Hepatic and Pancreatic Iron Overload in Thalassemia Major
- VernacularTitle:MRI-T2*检测β-重型地中海贫血心、肝、胰铁沉积的临床价值
- Author:
Jing-wen HUANG
1
;
Yun SU
1
;
Ji-xin LI
1
;
Qi-hua YANG
1
;
Bi-ling LIANG
1
Author Information
1. Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
- Publication Type:Journal Article
- Keywords:
thalassemia;
magnetic resonance imaging;
heart;
liver;
pancreas;
iron
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2020;41(4):611-619
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To quantify the myocardial, hepatic and pancreatic iron overload in β-thalassemia major(β-TM) using MRI T2* technique, and to analyze the relationship of iron deposition between the liver, pancreas and myocardium. 【Methods】 A total of 109 β-TM patients were enrolled in this retrospective study. Clinical and laboratory data were collected and patients were performed 1.5T T2* sequence MR scan on the heart, liver and pancreas. The spearman rank correlation was employed to analyze the relationship between liver T2*, pancreas T2* and myocardium T2*. Wilcoxon rank sum test was used to compare liver T2* values in the two groups: group A(n=32) with patients suffering from both myocardium iron overload(MIO) and liver iron overload(LIO), group B(n=69) with patients suffering from LIO only. Wilcoxon rank sum test was used to compare pancreas T2* values in another two groups: group C(n=34) with patients suffering from both MIO and pancreas iron overload(PIO), group D(n=58) with patients suffering from PIO only. Receiver operating characteristic(ROC) analysis was used to calculate the possibility of using hepatic and pancreatic iron as a predictor of myocardium iron deposition. 【Results】 The median T2* of myocardium, liver and pancreas of the 109 β-TM patients was 27.7(3.2~45.4) ms, 1.8(0.7~18.6) ms, 6.1(1.1~42.9) ms, respectively. With the cut-off level of 20 ms, MIO was detected in 34 cases(31.2%), the youngest one being 7 years old. With the cut-off level of 6.3 ms, LIO was detected in 101 cases(92.7%), the youngest being 5 years old. With the cut-off level of 26 ms, PIO was detected in 92 cases(84.4%), the youngest being 5 years old. Both liver T2*(r= 0.453, P<0.001) and pancreas T2*(r= 0.597, P<0.001) were positively correlated with myocardium T2*. Liver T2* values in group A were lower than those in group B(Z=3.048, P=0.002). Pancreas T2* values in group C were lower than those in group D(Z=6.682, P<0.001). ROC analysis of liver and pancreas R2*(1/T2*) for diagnosing MIO revealed significant distinguishing power of liver R2*(P=0.009) and pancreas R2*(P< 0.001), with area under the curve(AUC) of 0.660, 0.933 and 95% confidence interval of 0.543-0.777, 0.881-0.985, respectively. 【Conclusions】 Liver and pancreas iron overload occurr early and overwhelmingly in β-TM patients. Iron deposits earlier in the liver and pancreas than that in the myocardium. Both hepatic and pancreatic iron level are correlated with myocardial iron level, and can be predictors of the latter.
