Non-invasive depiction of hepatic and myocardial iron overload using MRI.

Abstract

Background and aim: In T2* MRI sequences, the susceptibility effect produced by iron accumulation results in a signal loss in the affected tissues. This effect aids the diagnosis of iron overload noninvasively, avoiding repeated invasive biopsies. The study aimed to document our initial experience of using MRI for measuring myocardial and hepatic iron for early management before severe cardiomyopathy and hepatic dysfunction.

Patient and methods: The study included 40 patients with chronic hemolytic anemias (36 ß thalassemia and 4 sickle cell anemia), 20 male and 20 female. The transfusion of all patients was dependent on regular and frequent blood transfusions.

Results: About 90% of patients have no myocardial iron overload, 5% have mild myocardial iron overload, and 5% have moderate to extreme myocardial iron overload. There was a negative correlation between myocardial iron overload and serum ferritin level among the studied patients. There was a positive correlation between hepatic iron overload and serum ferritin level. There was an insignificant positive correlation between hepatic and myocardial iron overload.

Conclusion: The myocardial and hepatic iron quantification can be reproducibly evaluated utilizing MRI to anticipate the iron chelation requirement and treatment of ventricular dysfunction. Myocardial iron overload can not be anticipated from the serum ferritin level or liver iron. Patients with advanced illnesses can only be detected using traditional heart function tests. The early increase of chelation treatment ought to decrease mortality from reversible cardiomyopathy.