Assessment of iron distribution between liver, spleen, pancreas, bone marrow, and myocardium by means of R2 relaxometry with MRI in patients with beta-thalassemia major.
OBJECTIVE
To investigate the correlation between the degree of hepatic, splenic, pancreatic, vertebral bone marrow (VBM), and myocardial siderosis, as expressed by relaxation rate (R2 = 1/T2) values, in patients with thalassemia.


METHODS
R2 relaxation rate values of liver, spleen, VBM, pancreas, and myocardium were estimated in 68 consecutive transfusion-dependent patients with beta-thalassemia major and 10 healthy controls using a respiratory triggered 16-echo Carr-Purcell-Meiboom-Gill (CPMG) spin echo sequence.


RESULTS
Hepatic R2 values were significantly increased in all 68 patients; VBM, pancreatic, and myocardial R2 values were increased in 67/68, 35/47, and 47/61 patients, whereas five patients showed decreased pancreatic R2 attributed to fatty degeneration. Of the 39 nonsplenectomized patients, splenic R2 values were decreased in 30 and normal in nine patients. Hepatic R2 values correlated with splenic (r = 0.63, P < 0.001), VBM (r = 0.52, P < 0.001), but not with myocardial and pancreatic R2 values.


CONCLUSIONS
Despite positive correlations between the degree of hepatic, splenic, and VBM siderosis, as expressed by respective R2 values, there was variability of iron distribution patterns in thalassemic patients. Unpredictable patterns of iron distribution may be seen, such as normal signal of the spleen in the presence of siderotic liver, resembling primary hemochromatosis. Fatty degeneration of the pancreas was not uncommon.
Papakonstantinou
Olympia
O
2nd Department of Radiology, National and Kapodistrian University of Athens, Greece.
Alexopoulou
Efthymia
E
Economopoulos
Nikos
N
Benekos
Odysseas
O
Kattamis
Antonis
A
Kostaridou
Stavroula
S
Ladis
Vasilis
V
Efstathopoulos
Efstathios
E
Gouliamos
Athanassios
A
Kelekis
Nikolaos L
NL
D000293:Adolescent; D000328:Adult; D001853:Bone Marrow / Q000378:metabolism; D002648:Child; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007501:Iron / Q000378:metabolism*; D019190:Iron Overload / Q000175:diagnosis* / Q000209:etiology*; D008099:Liver / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009206:Myocardium / Q000378:metabolism; D010179:Pancreas / Q000378:metabolism; D013154:Spleen / Q000378:metabolism; D017086:beta-Thalassemia / Q000150:complications*
D007501:Iron