MRI for the determination of pituitary iron overload in children and young adults with beta-thalassaemia major.
Hypogonadism, resulting from iron-induced pituitary dysfunction, is the most frequently reported complication in patients with beta-thalassaemia major. The aim of this study was to evaluate pituitary Magnetic Resonance Imaging (MRI) signal intensity reduction, on T2*-weighted images, as a marker of pituitary iron overload. Thirty patients (13 females and 17 males, mean age: 16.6+/-4.1) with beta-thalassaemia major on conventional treatment and 13 healthy volunteers (7 females and 6 males, mean age: 11+/-4.51 years) were studied with T2*-weighted images of the anterior pituitary using a 1.5T unit. Four thalassaemic patients (2 females and 2 males) had clinical hypogonadism and required hormonal replacement treatment. Results revealed a statistically significant reduction of pituitary signal intensity in the thalassaemia group compared to controls (p<0.001). Moreover, hypogonadal patients had significantly decreased MRI values compared to thalassaemic patients without hypogonadism (p=0.017). Relatively decreased adeno-hypophyseal MRI signal intensity was recorded in pubertal thalassaemic patients. A significant negative correlation was observed between pituitary MRI values and age (r=-0.67, r(2)=0.443, p=0.001), whereas ferritin levels and pituitary MRI values were moderately correlated (r=-0.56, r(2)=0.32, p=0.08) in adult thalassaemic patients. In conclusion, pituitary MRI indices as measured on T2*-weighted images seem to reflect pituitary iron overload and could, therefore, be used for a preclinical detection of patients who are in greater danger of developing hypogonadism.
Christoforidis
Athanasios
A
Thalassaemia Unit, Hippokration Hospital, 49 Konstantinoupoleos str., 54642 Thessaloniki, Greece. christoforidis@doctors.org.uk
Haritandi
Afroditi
A
Perifanis
Vassilios
V
Tsatra
Ioanna
I
Athanassiou-Metaxa
Miranda
M
Dimitriadis
Athanasios S
AS
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007501:Iron / Q000378:metabolism*; D019190:Iron Overload / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010902:Pituitary Gland / Q000378:metabolism*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D017086:beta-Thalassemia / Q000378:metabolism*
D007501:Iron