Role of cardiac magnetic resonance T1 mapping in comparison to T2* for cardiac iron overload assessment in transfusion-dependent thalassemia major patients

Abstract

Abstract Background Cardiac complications are the leading cause of death in transfusion-dependent thalassemia major (TDT) patients due to increased cardiac iron overload (CIO), so this study’s purpose is to assess the diagnostic utility of cardiac magnetic resonance T1 mapping in correlation to T2* for the assessment of CIO in TDT patients. This prospective case–control study involved 55 TDT patients and 30 age- and gender-matched healthy controls. All the patients underwent assessment of myocardial T2*, and native T1 values by conventional cardiac magnetic resonance imaging, and native T1 mapping technique to assess the CIO. Comparison and association between T2*, and native T1 values among TDT patients were studied. Results A statistically significant difference is noted between control and patient groups in regard to mean T2* and native T1 values (P = 0.03 and 0.01, respectively). The mean native T1 value in TDT patients was lower than in the control group (992 ± 54 vs. 1234 ± 42), respectively, with a statistically significant P value of 0.04. The study evoked a statistically significant strong positive association, and correlation was noted between measured T2* and native T1 values (r = 0.84, P value = 0.001), while a moderate negative association was observed between native T1 values and S. ferritin levels (r = − 0.53, P value = 0.02). Conclusions Native T1 mapping is a non-invasive promising complementary technique to T2* that helps to detect cardiac iron overload in TDT patients, as it is strongly associated with T2*. Also, native T1 value can differentiate mild, moderate, severe, and no cardiac iron overload.

Keywords

• Cardiac magnetic resonance
• Iron overload
• T1 mapping
• T2*
• Thalassemia