MRI Evaluation of Hepatic Iron Overload in b-Thalassemic Children

Abstract
Background:  b-Thalassaemia major is a hereditary hemo-lytic anemia that have amajor complication iron overload. Assessment of Liver Iron Concentration (LIC) is necessary for detection and quantitative staging of iron overload and monitoring of iron-reducing treatments. MRI represents the most available noninvasive technique to assess LIC.
The aim of this study was to assess LIC by MRI in multitransfused b-Thalassemic children.
Patients and Methods: Forty multi-transfused b-thalassemic children were subjected to clinical evaluation, appropriate laboratory assessment and assessment of LIC by MRI.
T2* weighted gradient echosequence MRI was performed with 1.5T scanner.
Results:
- Significant reduction in signal intensity ratio of the liver was show in all patients.
- Highly significant correlation between MRI parameter (R2* and T2*) and LIC (p<0.001).
- Moderate significant correlation between MRI parameters (R2*, T2*) and SF level when serum Ferrittin below 4000 ng/dl and non-significant when SF above 4000ng/dl (p>0.05).
- Splenectomizied patients had significant lower SIR of liver (decrease R2* and increase T2*) compared to non splenec-tomized patients (p<0.007).
Conclusion: In conclusion based on results of our study MRI is the best noninvasive method for assessment and evaluation of hepatic iron overload and determine its severity in multi-transfused b-thalassemic patients.