R2 relaxometry with MRI for the quantification of tissue iron overload in β-thalassemic patients

✍ Scribed by Efthymia Alexopoulou; Fotini Stripeli; Panagiotis Baras; Ioannis Seimenis; Antonis Kattamis; Vasilis Ladis; Efstathios Efstathopoulos; Elias N. Brountzos; Alexis D. Kelekis; Nikolaos L. Kelekis

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 436 KB
• Volume: 23
• Category: Article
• ISSN: 1053-1807
• DOI: 10.1002/jmri.20489

✦ Synopsis

Abstract

Purpose

To evaluate the usefulness of a time‐efficient MRI method for the quantitative determination of tissue iron in the liver and heart of β‐thalassemic patients using spin‐spin relaxation rate, R2, measurements.

Materials and Methods

Images were obtained at 1.5 T from aqueous Gd‐DTPA solutions (0.106–8 mM) and from the liver and heart of 46 β‐thalassemic patients and 10 controls. The imaging sequence used was a respiratory‐triggered 16‐echo Carr‐Purcell‐Meiboom‐Gill (CPMG) spin‐echo (SE) pulse sequence (TR = 2000 msec, TE~min~ = 5 msec, echo spacing (ES) = 5 msec, matrix = 192 × 256, slice thickness = 10 mm). Liver iron concentration (LIC) measurements were obtained for 22 patients through biopsy specimens excised from the relevant liver segment. Biopsy specimens were also evaluated regarding iron grade and fibrosis. Serum ferritin (SF) measurements were obtained in all patients.

Results

A statistically significant difference was found between patients and healthy controls in mean liver (P < 0.004) and myocardium (P < 0.004) R2 values. The R2 values correlated well with Gd DTPA concentration (r = 0.996, P < 0.0001) and LIC (r = 0.874, P < 0.0001). A less significant relationship (r = 0.791, P < 0.0001) was found between LIC measurements and SF levels. R2 measurements appear to be significantly affected (P = 0.04) by different degrees of hepatic fibrosis. The patients' liver R2 values did not correlate with myocardial R2 values (r = 0.038, P < 0.21).

Conclusion

Tissue iron deposition in β‐thalassemic patients may be adequately quantified using R2 measurements obtained with a 16‐echo MRI sequence with short ES (5 msec), even in patients with a relatively increased iron burden. J. Magn. Reson. Imaging 2006. © 2005 Wiley‐Liss, Inc.