Hepatic Iron Overload in Transfusion Dependent Chronic Hemolytic Anemic Patients: Where Does MRI R2* Relaxometry Stand? | ||||
| The Medical Journal of Cairo University | ||||
| Article 24, Volume 88, June, June 2020, Page 1187-1192 PDF (349.3 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjcu.2020.110868 | ||||
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| Author | ||||
| WESSAM A. ELZAYAT, M.D.; MONA EL-KALIOUBIE, M.D. | ||||
| The Department of Diagnostic and Intervention Radiology, Faculty of Medicine, Cairo University | ||||
| Abstract | ||||
| Abstract Background: Hepatic iron overload in pediatric population with repeated blood transfusion is an important morbidity warranting the evolution of a noninvasive method of liver iron quantification. MR T2*/R2* relaxometry technique has shown promising results in this domain. Aim of Study: To show the value of MR T2*/R2* relax-ometry technique, in assessment of hepatic iron overload in a sample pediatric patient population at our hospital on repeated blood transfusions therapy for thalassemia and sickle cell anemia. Patients and Methods: A total of 44 patients, mean age 11.14±3.38 (range: 6-17 years old) patients with thalassemia and sickle cell anemia who had received more than 20 blood transfusions and on chelation therapy at the time of the examination, underwent MRI T2*/R2* relaxometry study. The corresponding iron overload was calculated for each patient, then correlation between R2* and serum ferritin level was done by using Pearson's correlation coefficient. Results: Serum ferritin levels ranged between 56.7 and 11524ng/mL (mean 3605.8ng/mL). R2* values ranged between 77.1 and 11426Hz (mean 2361Hz). Based on the calculated Liver Iron Concentrations (LIC) values which ranged between 0.47 and 42.55mg/g (mean 11.38mg/g) 9 patients (20.45%) showed normal hepatic iron load, 10 patients (22.73%) showed mild iron overload, 13 patients (29.55%) showed moderate overload and 12 patients (27.27%) showed severe overload. The correlation between R2* and serum ferritin was a weak positive one with a Pearson's coefficient of 0.49 (p=0.000645). The correlation between LIC and serum ferritin was a moderate positive one with a Pearson's correlation of 0.5 (p=0.000494). Conclusion: Quantification of liver iron deposition in children with chronic hemolytic anemia receiving multiple blood transfusions is empirical for chelation therapy monitor-ing. R2* relaxometry shows promising results as an effective quantitative tool for estimation of hepatic iron overload when compared to serum ferritin levels, therefore providing a safer alternative in contrast to tissue biopsy. | ||||
| Keywords | ||||
| Chronic hemolytic anemia; Iron overload; Liver MRI | ||||
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