MRI Evaluation of Hepatic Iron Overload in Chronically Transfused P-Thalassemic Children

Abstract
Background: Patients with chronic hemolytic anemia like thalassemia need repeated blood transfusions which lead to iron overload. MRI has emerged for the noninvasive assessment of iron overload in various tissues.
Aim of Study: The aim of this study is to assess the role of MRI in the evaluation of hepatic iron overload in multi transfused P-Thalassemic children and to correlate the results with serum ferritin levels.
Patients and Methods: In 45 cases of multi-transfused child with thalassemia, Liver Iron Concentration (LIC) was measured by MRI T2* and compared to serum ferritin (tradi-tional marker of iron overload).
Results: There were a significant positive correlation between serum ferritin and LIC (r=0.557 and p<0.01) when SF level below 4000ng/ml, and the correlation became very weak when serum ferritin above 4000ng/ml. Also, there were a significant negative correlation of LIC with T2* (r=–0.999 and p<0.01) and a significant positive correlation with R2* (r=1.000 and p<0.01) and no significant correlation with age, sex, splenectomy and frequency of blood transfusion.
Conclusion: MRI T2* provides accurate reproducible and non-invasive technique for assessing tissue iron concentration. Through the widespread application of this technique it should be possible to improve management of tissue iron overload allowing earlier chelation intensification.