Iron Overload Assessment in Adult Thalassaemic Patients Using MRI T2
d anemia in our country. Blood transfusion is the continual treatment of this disease. But transfusion causes a serious side effect which is iron overload in vital organs such as the heart, liver and the endocrine system. Accumulated iron in these organs may cause high risk secondary problems which threaten the patients' life. Early assessment of the iron overload in vital organs and applying for early treatment can be beneficial for increasing life quality in these patients. Assessment of cardiac and hepatic iron overload using MRI T2 technique and comparing it with serum ferritin level was the goal of this study.
Materials and Methods: The referred thalassaemic patients to Zafar adult thalassaemia clinic were the population of this study. Serum ferritin test was carried out for all these patients. Cardiac and hepatic iron overload assessment of these patients was performed in Noor medical imaging center using MRI T2 technique. The iron overload results of all patients were classified as normal, mild, moderate and severe. We compared them with the patients’ clinical parameters, especially the serum ferritin level. Results were analyzed by SPSS software.
Results: 700 adult patients with the mean age of 25.76 (SD±10.4) were studied in this research project. There were 360 males (51.4%) and 340 (48.6%) females enrolled in this study. Among them, there were 502 (71.7%) major thalassaemia, 158 (22.6%) intermediate thalassaemia, 7 alpha thalassaemia, 9 sickle cell anemia and 10 hemochromatosis patients. The mean of serum ferritin level was 2327.6 mg/dl (SD±2095.8). Classified results of cardiac iron overload assessment were normal in 366 (66.5%) patients, mild in 44 (8%) patients, moderate in 64 (11.6%) patients, and severe in 76 (13.8%)patients. The classified results of hepatic iron overload assessment were: normal in 122 (22.2%) patients, mild in 137 (25%) patients, moderate in 235 (42.8%) patients and severe in 55 (10%) patients. Iron overload in the liver was more obvious than in the heart. There was a meaningful correlation between quantitative hepatic iron overload and serum ferritin level (P value=0.000).
Conclusions: In this study, in patients with serum ferritin levels less than 1500, there was hepatic iron overload. As testing the serum ferritin level was our only before criteria for treatment, this caused a lighter iron chelating regimen in these patients. As a result, iron overload evaluation by the MRI T2 imaging method is very helpful.