title: Bone marrow changes in beta-thalassemia major: quantitative MR imaging findings and correlation with iron stores.
abstract: The purpose of this study is to describe the MR imaging features of bone marrow in beta-thalassemia major and investigate their relation to ferritin, liver and spleen siderosis. Spinal bone marrow was prospectively assessed on abdominal MR studies of 40 transfused beta-thalassemic patients and 15 controls using T1-w, Pd, T2*-w Gradient Echo (GRE) and T1-w turbo Spin Echo (TSE) sequences. Signal intensity (SI) ratios of liver, spleen and bone marrow to paraspinous muscles (L/M, S/M, B/M respectively) and the respective T2 relaxation rates (1/T2) were calculated. Serum ferritin levels were recorded. Bone marrow hypointensity in at least T2*-w GRE sequence was noted in 29/40 (72.5%) patients. Eleven/40 patients exhibited normal B/M on all MR sequences. Five/40 patients had normal B/M and low L/M. B/M correlated with L/M in T1-w TSE sequence only (r = 0.471, p = 0.05). B/M correlated with S/M and mean ferritin values in all sequences (r > 0.489, p < 0.01 and r > - 0.496, p < 0.03 respectively). Marrow 1/T2 did not correlate with ferritin values or liver and spleen 1/T2. B/M in transfused beta-thalassemic patients is related to splenic siderosis and ferritin levels. Although marrow is usually hypointense, it may occasionally display normal SI coexisting with liver hypointensity, a pattern typical of primary hemochromatosis.
authors.affiliation: Radiology Department, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece.
authors.forename: Eleni E
authors.initials: EE
authors.lastname: Drakonaki
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Maris
authors.forename: Alex
authors.initials: A
authors.lastname: Papadakis
authors.forename: Apostolos H
authors.initials: AH
authors.lastname: Karantanas
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001853:Bone Marrow / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D019190:Iron Overload / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D017086:beta-Thalassemia / Q000473:pathology*