Multislice multiecho T2* cardiovascular magnetic resonance for detection of the heterogeneous distribution of myocardial iron overload.
OBJECTIVE
To assess the tissue iron concentration of the left ventricle (LV) using a multislice, multiecho T2* MR technique and a segmental analysis.


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).


CONCLUSIONS
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.
MRI Laboratory, Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy. alepepe@email.it
Alessia
A
Pepe
Vincenzo
V
Positano
Maria Filomena
MF
Santarelli
Fortunato
F
Sorrentino
Eliana
E
Cracolici
Daniele
D
De Marchi
Aurelio
A
Maggio
Massimo
M
Midiri
Luigi
L
Landini
Massimo
M
Lombardi
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005293:Ferritins / Q000097:blood; D006352:Heart Ventricles / Q000378:metabolism; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007501:Iron / Q000378:metabolism / Q000652:urine; D019190:Iron Overload / Q000175:diagnosis* / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D015588:Observer Variation; D015203:Reproducibility of Results; D017086:beta-Thalassemia / Q000150:complications
D005293:Ferritins; D007501:Iron