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• Clinical Article •
Value of liver T2* and SF to predict myocardial iron concentration patients with thalassemia
LI Da-chuang  HUANG Hai-bo  YIN Xiao-lin  ZHOU Ya-li  GUAN Jun  QIN Ming  HUANG Gui-xiong 

DOI:10.12015/issn.1674-8034.2016.12.004.


[Abstract] Objective: To quantify the MIC, liver iron concentration (LIC) in TM patients and discuss the value of liver T2*, SF to predict the MIC.Materials and Methods: Study protocol was approved by local ethics committee; informed consent was obtained. A total of 113 TM patients diagnosed by gene were enrolled. A multiple fast-field echo (mFFE) within a single breath-hold was performed using a 3.0 Tesla MR unit to acquire 8 or 12 T2* weighted images in the heart or liver. T2* values of myocardium and liver were quantified based on mFFE T2* protocol by a well-trained physician respectively, SF was obtained twice within 7 days before and after MRI. Spearman rank correlation was applied to analyze the relationships among the MIC, LIC and SF. The ROC curve was drawn to predict the possibility of using liver T2*<0.70 ms, SF>2500 μg/L as an index of cardiac iron deposition, and the possibility of using SF>300 μg/L as an index of liver iron overload.Results: A total of 113 patients, the grades of body iron deposition as following: nineteen out of 113 were found to have myocardial excess iron, including 3 severe cases, 10 moderate cases, and 6 mild cases; 100 out of 113 were found to be liver excess iron, including 15 very severe cases, 25 severe cases, 29 moderate cases, and 31 mild cases; 112 out of 113 patients were found to be abnormal SF, including 12 very severe cases, 35 severe cases, 17 moderate cases, and 48 mild cases. There was weakly or moderate correlation between myocardial T2* and liver T2* (rs=0.267, P=0.004), myocardial T2* and SF (rs=-0.463, P=0.000), as well as between liver T2* and SF (rs=-0.641, P=0.000), but no clear regularity. To predict cardiac iron deposition with myocardial T2*<10 ms as diagnostic criteria, the accuracies, sensibilities and specificities were 76.9%, 75% and 77.1% for the index of liver T2*<0.70 ms, 82.7%, 68.8% and 68.6% for SF>2500 μg/L, respectively. Moreover, to predict liver excess iron with liver T2*<3.57 ms as standard setting, the accuracy, sensibility and specificity were respectively 80.2%, 92.4% and 20.7% for the index of SF>2500 μg/L.Conclusion: Within a certain limits, MRI T2* technique could directly quantify the MIC and LIC, there was weakly or moderate correlation among MIC, LIC and SF, but no clear regularity. Using LIC or SF as an indirect index to predict cardiac excess iron were low valuable, meanwhile, using SF to predict liver iron overload was not reliable in clinical.
[Keywords] Thalassemia；Magnetic resonance imaging；Serum ferritin；Myocardium；Iron overload

LI Da-chuang Department of Medical Imaging, 303rd Hospital of PLA, Nanning 530021, China

HUANG Hai-bo* Department of Medical Imaging, 303rd Hospital of PLA, Nanning 530021, China

YIN Xiao-lin Department of Haematology, 303rd Hospital of PLA, Nanning 530021, China

ZHOU Ya-li Department of Haematology, 303rd Hospital of PLA, Nanning 530021, China

GUAN Jun Department of Medical Imaging, 303rd Hospital of PLA, Nanning 530021, China

QIN Ming Department of Medical Imaging, 303rd Hospital of PLA, Nanning 530021, China

HUANG Gui-xiong Department of Medical Imaging, 303rd Hospital of PLA, Nanning 530021, China

*Correspondence to: Huang HB, E-mail:jackie000528@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of Guangxi Natural Science Foundation of China No. 2014GXNSFBA118187, 2015GXNSFAA139164
Received  2016-09-09
Accepted  2016-10-26
DOI: 10.12015/issn.1674-8034.2016.12.004
DOI:10.12015/issn.1674-8034.2016.12.004.

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