MRI assessment of excess cardiac iron in thalassemia major: When to initiate?. Issue 3 (7th July 2015)

• Record Type: Journal Article
• Authors: Chen, Xiaodong; Zhang, Zuoquan; Zhong, Jinglian; Yang, Qihua; Yu, Taihui; Cheng, Ziliang; Chan, Queenie; Guo, Hua; Liang, Biling
• Is Part Of: Journal of magnetic resonance imaging. Volume 42:Issue 3(2015)
• Page Start: 737
• Page End: 745
• Publication Date: 2015-07-07
• Subjects: Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.24781
• Languages: English
• ISSNs: 1053-1807

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jmri24781-sec-0001" sec-type="section"> <title>Background</title> <p>To determine optimal initial age of cardiac iron screening with magnetic resonance imaging (MRI) T2* in patients with thalassemia major (TM).</p> </sec> <sec id="jmri24781-sec-0002" sec-type="section"> <title>Methods</title> <p>We retrospectively reviewed black blood cardiac T2* assessments from 102 TM patients from the ages of 3 to 32 years. Cases of patients under and above 7 years old with detectable cardiac iron overload were analyzed separately. Associations between cardiac T2* and various factors, such as serum ferritin (SF), patient age and hepatic T2*, were assessed using either scatterplots or regression. Images were evaluated by two independent radiologists.</p> </sec> <sec id="jmri24781-sec-0003" sec-type="section"> <title>Results</title> <p>With a T2* cut‐off value of 20 ms, no patient under 5 years old showed cardiac iron overload. Three of 19 (15.8%) patients under 7 years of age had a cardiac T2* ≤ 20 ms (5.5 to 7 years) but none had ≤10 ms, while 35 of 83 (42.2%) patients above 7 years old had a cardiac T2* ≤ 20 ms (8 to 32 years) and 18 of them ≤10 ms. Cardiac T2* correlated weakly with serum ferritin and liver T2* (<italic>r</italic> = −0.39 and 0.41, respectively, both <italic>P</italic> < 0.001), but not with patient age (<italic>P</italic> > 0.05).</p> </sec> <sec id="jmri24781-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Cardiac iron overload can occur in young TM patients, even as young as 5.5 years old. Assessment of cardiac iron with T2* might need to begin as early as 5 years old if suboptimal chelation therapy is administered. J. Magn. Reson. Imaging 2015;42:737–745.</p> </sec> </abstract>