Carlo Ottonello, Abstract Co-Author: Nothing to Disclose

Antonello Giardino MD, Presenter: Nothing to Disclose

Cristiano Turchetti MD, Abstract Co-Author: Nothing to Disclose

Francesco Secchi MD, Abstract Co-Author: Nothing to Disclose

Giovanni Di Leo, Abstract Co-Author: Nothing to Disclose

Francesco Sardanelli MD, Abstract Co-Author: Consultant, Bracco Group

To evaluate myocardial iron storage and EF in patients affected with thalassemia major (TM) using T2*-weighted MR sequences.

Eighty-four TM patients (46 males; mean age 32±9 years; range 15-69) treated with long-term desferoxamine, deferiprone or both underwent 1.5-T MRI (Intera, Philips) with dual-echo T2*-weighted 4-chambers long-axis fast-field-echo sequence (TR = 12 ms; TE1 = 4.6 ms; TE2 = 9.2 ms; flip angle 30°; slice thickness 10 mm). For each patient, we measured signal intensity (SI) for three small regions of interest placed in basal, middle, and apical interventricular septum. T2* was calculated using the following formula: T2* =-ΔTE/ln(SITE2/SITE1). A mean myocardial T2* was calculated for each patient based on the three regions of interest and a T2*<20 ms was considered as a sign of iron storage. LVEF was obtained from standard short-axis cine steady state free precession sequences and automated segmentation protocol. Serum ferritin concentration (SFC) was measured with the immunoenzimathic method and the mean value of the previous 12 months was considered. Spearman correlation analysis and Mann-Whitney U test were used.

Myocardial T2* was 26±12 ms (mean±standard deviation; median 28 ms), LVEF was 56±7% (median 58%); SFC ranged from 110 ng/mL to 12,000 ng/mL (median 865 ng/mL). Out of 84 patients, 25 (30%) had myocardial T2* <20 ms. Median SFC was 1800 ng/mL for the 25 patients with myocardial T2* <20 ms and 820 ng/mL for the 59 patients with myocardial T2* ≥20 ms (P=.055). The Spearman correlation coefficient between T2* and SFC was -0.163 (P=.140) and between T2* and LVEF was 0.235 (P=.031), that between SFC and LVEF was -0.339 (P=.002).

Despite long-term iron-chelating therapy, about one third of the TM patients had abnormal myocardial T2* values. The lower the T2*, the lower the LVEF, and a significant negative correlation was also found between SFC and LVEF.

Patients with thalassemia major may be assessed using MRI which is able to monitor change of iron storage.

Ottonello, C, Giardino, A, Turchetti, C, Secchi, F, Di Leo, G, Sardanelli, F, Magnetic Resonance (MR) Evaluation of Myocardial T2* Relaxation Time and of Left Ventricle Ejection Fraction (LVEF) in Thalassemic Patients.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9014115.html