title: Multislice multiecho T2* cardiac magnetic resonance for the detection of heterogeneous myocardial iron distribution in thalassaemia patients.
abstract: The present study investigated myocardial T2* heterogeneity in thalassaemia major (TM) patients by cardiac magnetic resonance (CMR), to determine whether is related to inhomogeneous iron overload distribution. A total of 230 TM patients consecutively referred to our laboratory were studied retrospectively. Three short-axis views (basal, medium and apical) of the left ventricle (LV) were obtained by multislice multiecho T2* CMR. T2* segmental distribution was mapped on a 16-segment LV model. The level of heterogeneity of the T2* segmental distribution, evaluated by the coefficient of variation (CoV), was compared with that of a surrogate data set, to determine whether the inhomogeneous segmental distribution of T2* could be generated by susceptibility artefacts. Susceptibility artefacts offer an explanation for the T2* heterogeneity observed in patients without iron overload. In subjects with global T2* below the lower limit of the normal, T2* heterogeneity increased abruptly which could not be explained by artefactual effects. Some segmental T2* values were below and others above the limit of normal threshold (20 ms) in 104 (45%) TM patients. Among these patients, 74% showed a normal T2* global value. In conclusion, a true heterogeneity in the iron overload distribution may be present in TM patients. Heterogeneity seemingly appears in the borderline myocardial iron and stabilizes at moderate to severe iron burden.
authors.affiliation: G. Monasterio Foundation and CNR Institute of Clinical Physiology, Pisa, Italy. positano@ifc.cnr.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Positano
authors.forename: Alessia
authors.initials: A
authors.lastname: Pepe
authors.forename: Maria Filomena
authors.initials: MF
authors.lastname: Santarelli
authors.forename: Anna
authors.initials: A
authors.lastname: Ramazzotti
authors.forename: Antonella
authors.initials: A
authors.lastname: Meloni
authors.forename: Daniele
authors.initials: D
authors.lastname: De Marchi
authors.forename: Brunella
authors.initials: B
authors.lastname: Favilli
authors.forename: Eliana
authors.initials: E
authors.lastname: Cracolici
authors.forename: Massimo
authors.initials: M
authors.lastname: Midiri
authors.forename: Anna
authors.initials: A
authors.lastname: Spasiano
authors.forename: Massimo
authors.initials: M
authors.lastname: Lombardi
authors.forename: Luigi
authors.initials: L
authors.lastname: Landini