MR T2* Evaluation of the Hepatic and Myocardial Iron Deposition in Thalasemia Major Patients and the Correlation of the Results with Serum Ferritin Levels and Cardiac Functions

Abstract

INTRODUCTION: The purpose of this study was to evaluate the correlation between myocardial iron deposition and cardiac functions along with the correlations between myocardial iron deposition, hepatic iron deposition and serum ferritin levels in beta thalasemia major patients. METHODS: 145 beta thalasemia major patients (85 males and 60 females age between 9-53 years) between March 2016 and September 2018 and were retrospectively evaluated. T2* calculations were done for the heart and the liver. For functional evaluation of the heart, left ventricular ejection fraction calculation and wall motion analysis were done. The serum ferritin levels between 20-250 ng/ml were accepted as normal. The correlation between myocardial iron deposition and cardiac functions as well as the correlations between myocardial iron deposition, hepatic iron deposition and serum ferritin levels were statistically evaluated. RESULTS: The statistical analysis revealed a significant correlation between cardiac functional abnormalities and the severity of myocardial iron deposition. A statistically significant correlation was also found between myocardial iron deposition and serum ferritin levels in regard of both the presence and severity. Similarly, hepatic iron deposition and serum ferritin levels were found to be correlated. On the other hand, no statistically significant correlation was detected between hepatic and cardiac iron accumulations. DISCUSSION AND CONCLUSION: MRI is an accurate tool to quantatively evaluate hepatic and myocardial iron deposition in thalasemia major patients. The periodical follow up of patients with MRI examinations for hepatic and myocardial iron deposition in addition to serum ferritin levels may help to modify the treatment in patients with transfusion dependent anemias.

Keywords

• iron overload
• myocardial iron
• hepatic iron
• magnetic resonance imaging
• thalasemia major