Hepatic iron overload in thalassemic patients: proposal and validation of an MRI method of assessment.
BACKGROUND
A simple, accurate, reproducible and noninvasive method of body iron overload assessment would be of great clinical use. Objective. The purpose of the study was the implementation of a 0. 5-T MRI method for liver iron overload measurement.


METHODS
Thirty patients with thalassemia major took part in the study. Liver and paraspinal muscle signal intensity (SI) measurements were performed on T1-weighted images and normalized on a standard phantom, and a subjective hemochromatosis grading scale was made on both T1- and T2-weighted images. Serum ferritin levels and tissue iron from liver biopsy specimens were determined for comparison.


RESULTS
A close correlation was found between bioptic liver iron and both the liver-to-phantom SI ratio (r = -0.88) and the subjective grading scale (rho = 0.89). Serum ferritin correlated poorly with liver iron deposition, whether assessed by biopsy (r = 0. 62) or MRI (r = -0.69).


CONCLUSIONS
Both the subjective and the quantitative MRI methods proposed here are clinically valuable, with the former being adequate for a gross, the latter for an accurate estimation of tissue iron overload.
Bonetti
M G
MG
1, Scalone San Francesco, I-60121 Ancona, Italy.
Castriota-Scanderbeg
A
A
Criconia
G M
GM
Mazza
P
P
Sacco
M
M
Amurri
B
B
Masi
C
C
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D005260:Female; D005293:Ferritins / Q000097:blood; D006432:Hemochromatosis / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012044:Regression Analysis; D015203:Reproducibility of Results; D017086:beta-Thalassemia / Q000097:blood / Q000150:complications / Q000175:diagnosis*
D005293:Ferritins; D007501:Iron