Turk J Haematol 2015 Aug 6

The Feasibility Of Mr Imaging For Quantification Of Liver, Pancreas, Spleen, Vertebral Bone Marrow And Renal Cortex R2*And Proton Density Fat Fraction In Transfusion Related Iron Overload.

İdilman İS, Gümrük F, Haliloğlu M, Karçaaltıncaba M1.
We aimed to evaluate the feasibility of quantification of liver, pancreas, spleen, vertebral bone marrow and renal cortex R2* and MRI-PDFF and to evaluate the correlations among them in patients with transfusion related iron overload.
l="AIM" NlmCategory="OBJECTIVE">We aimed to evaluate the feasibility of quantification of liver, pancreas, spleen, vertebral bone marrow and renal cortex R2* and MRI-PDFF and to evaluate the correlations among them in patients with transfusion related iron overload.

MATERIALS AND METHODS:

A total of 9 patients (5 boys, 4 girls) who were referred to our clinic with suspect of hepatic iron overload were included in this study. All patients underwent T1-independent volumetric multi-echo gradient-echo imaging with T2* correction and spectral fat modeling. MRI examinations were performed on a 1.5T MRI system.

RESULTS:

All patients had hepatic iron overload (HIO). Severe HIO was recorded in 5/9 patients (56%) and when we evaluated the PDFF maps of these patients we observed an extensive patchy artifact in the liver in 4 of 5 patients (R2* greater than 671 Hz). When we performed MRI-PDFF measurements despite these artifacts, we observed artifactual high MRI-PDFF values. There was a close correlation between average pancreas R2* and average pancreas MRI-PDFF (p= 0.003, r= 0.860). There was a significant correlation between liver R2* and average pancreas R2* (p= 0.021, r= 0,747), liver R2* and renal cortex R2* (p= 0.020, r= 0,750) and average pancreas R2* and renal cortex R2* (p= 0.003, r= 0,858). There was a significant negative correlation between vertebral bone marrow R2* and age (p= 0.018, r= - 0.759).

CONCLUSION:

High iron content of the liver, especially with a T2* value shorter than the first echo time can spoil the efficacy of PDFF calculation in liver and bone marrow. Fat deposition in pancreas is accompanied by pancreatic iron overload. There is a significant correlation between hepatic siderosis and pancreatic siderosis. Renal cortical and pancreatic siderosis are correlated too.