title: Iron overload detection using pituitary and hepatic MRI in thalassemic patients having short stature and hypogonadism.
abstract: OBJECTIVE
  to assess the growth and pubertal development among a group of patients with β-Thalassemia Major (β-TM) and to evaluate the role of the pituitary gland and liver MRI signal intensity (SI) reduction in assessing and predicting the clinical severity of growth and pubertal dysfunctions.
  
  
  METHODS
  Thirty-eight patients with β-TM were examined and divided into two groups: Group I patients were of normal height and puberty and Group II patients had short statures and hypogonadism. Laboratory investigations included serum ferritin, LH, FSH, prolactin, TSH, and basal and dynamic growth hormones. Pituitary and liver MRIs were performed to assess the pituitary to fat (P/F) and liver to muscle (L/M) signal intensities (SI), respectively. Fifteen healthy and sex- and age-matched subjects were included as controls.
  
  
  RESULTS
  Both patient groups had significantly elevated serum ferritin and significantly decreased prolactin and IGF1 compared to control subjects. Group II showed a significant reduction in LH, FSH, and IGF1 and a significant increase in ferritin in comparison with Group I and the control group, and it had a highly significant reduction in both P/F and L/M SI in comparison with Group I (p<0.001 and 0.008, respectively). The reduced P/F ratio was significantly correlated with FSH and LH, and a cutoff for a P/F ratio ≥0.94 was obtained to differentiate between Group I and II.
  
  
  CONCLUSIONS
  MRI in conjunction with the P/F signal intensity ratio is a useful and noninvasive tool for the early diagnosis of pituitary iron overload.
authors.affiliation: a Department of Internal Medicine, Faculty of Medicine , Mansoura University , Egypt .
authors.forename: Amany A
authors.initials: AA
authors.lastname: Mousa
authors.affiliation: a Department of Internal Medicine, Faculty of Medicine , Mansoura University , Egypt .
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ghonem
authors.affiliation: a Department of Internal Medicine, Faculty of Medicine , Mansoura University , Egypt .
authors.forename: El Hadidy M
authors.initials: el HM
authors.lastname: Elhadidy
authors.affiliation: b Department of Clinical Hematology, Faculty of Medicine , Mansoura University , Egypt.
authors.forename: Emad
authors.initials: E
authors.lastname: Azmy
authors.affiliation: c Department of diagnostic radiology, Faculty of Medicine , Mansoura University , Egypt.
authors.forename: Magda
authors.initials: M
authors.lastname: Elbackry
authors.affiliation: d Department of Clinical Pathology, Faculty of Medicine , Mansoura University , Egypt.
authors.forename: Azza A
authors.initials: AA
authors.lastname: Elbaiomy
authors.affiliation: e Department of clinical pathology, Faculty of Medicine , Mansoura University , Egypt.
authors.forename: Rasha R
authors.initials: RR
authors.lastname: Elzehery
authors.affiliation: f Department of Physiology, Faculty of Medicine , Mansoura University , Egypt.
authors.forename: Gehan A
authors.initials: GA
authors.lastname: Shaker
authors.affiliation: a Department of Internal Medicine, Faculty of Medicine , Mansoura University , Egypt .
authors.forename: Omyma
authors.initials: O
authors.lastname: Saleh
mesh_terms: D000293:Adolescent; D000328:Adult; D004392:Dwarfism / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D019190:Iron Overload / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D008099:Liver / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D010902:Pituitary Gland / Q000000981:diagnostic imaging*; D055815:Young Adult; D017086:beta-Thalassemia / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging
keywords: MRI; Pituitary; hypogonadism; short stature; β- Thalassaemia