MRI for Quantitative Determination of Iron in the Liver and Heart in Patients with Primary and Secondary Hemochromatoses in Association with Serrum Ferritin: Single-Stage Observational Study
- Authors: Titova A.M.1, Fokin V.A.1, Trufanov G.E.1, Shalygina K.S.1, Tsvetkova N.V.1
-
Affiliations:
- Almazov National Medical Research Centre
- Issue: Vol 78, No 1 (2023)
- Pages: 11-18
- Section: INTERNAL DISEASES: CURRENT ISSUES
- URL: https://vestnikramn.spr-journal.ru/jour/article/view/2328
- DOI: https://doi.org/10.15690/vramn2328
Cite item
Abstract
Background. An extremely small number of studies have been devoted to the study of differences in LIC (liver iron concentration) and MIC (myocardium iron concentration) indicators, as well as their correlation with each other and with ferritin levels in patients with various nosological forms. Aims to study the relationship of ferritin, LIC and MIC levels in patients with various causes of hemochromatosis (hereditary hemochromatosis (HH), aplastic anemia (AA), primary myelofibrosis (PMF), thalassemia (TL), myelodysplastic syndrome (MDS)). Methods. The design of the study is a single–stage observational one. The study included 91 patients with primary hemochromatosis and secondary transfusion-dependent hemochromatosis receiving regular blood transfusion and iron chelate therapy from 2015 to 2018. The studies were carried out on 1.5 T MR-scanner Magnetom Espree (Siemens, Germany), and myocardial iron concentration (MIC) was calculated using the formula MIC = 45 × (T2*) – 1.22. Liver iron concentration (LIC) was calculated using the formula LIC = 0.03 × R2* + 0.74. The ferritin level was determined by enzyme immunoassay. Statistical processing of the results obtained was carried out using the SPSS software package. Results. Connections between LIC and ferritin (r = 0.867; p < 0.001), MIC and ferritin (r = 0.759; p = 0.004) and LIC and MIC (r = 0.737; p = 0.006) were found in patients with primary hemochromatosis, while in patients with secondary hemochromatosis significant correlations were found only between LIC and MIC (r = 0.503; p < 0.001), while the relationship was average. Links between LIC and ferritin were found in patients with AA (r = 0.656; p = 0.040), an average relationship, in patients with TL (r = 0.714; p = 0.020), an average relationship. The relationship between MIC and ferritin was revealed in patients with AA (r = 0.703; p = 0.050), an average relationship, in patients with TL (r = 0.757; p = 0.018), an average relationship. At the same time, in patients with MDS and PMF in this study, there was no association between ferritin and LIC, ferritin and MIC. Conclusions. In patients with hereditary hemochromatosis, LIC and MIC are associated with ferritin, and MIC is also associated with LIC (medium bond). In patients with iron overload due to thalassemia, an average correlation between LIC and ferritin, MIC and ferritin was revealed. In patients with iron overload due to aplastic anemia, an average correlation between LIC and ferritin, MIC and ferritin was revealed.
Keywords
Full Text

About the authors
Anna M. Titova
Almazov National Medical Research Centre
Email: anisa33@mail.ru
ORCID iD: 0000-0002-6605-0663
SPIN-code: 2243-6599
MD
Russian Federation, Saint PetersburgVladimir A. Fokin
Almazov National Medical Research Centre
Email: vladfokin@mail.ru
ORCID iD: 0000-0002-2937-6322
SPIN-code: 6072-3550
MD, PhD, Professor
Russian Federation, Saint PetersburgGennadii E. Trufanov
Almazov National Medical Research Centre
Email: trufanovge@mail.ru
ORCID iD: 0000-0002-1611-5000
SPIN-code: 3139-3581
MD, PhD, Professor
Russian Federation, Saint PetersburgKsenia S. Shalygina
Almazov National Medical Research Centre
Email: shalygina_k98@mail.ru
ORCID iD: 0000-0001-5000-3582
Clinical Resident
Russian Federation, Saint PetersburgNadezhda V. Tsvetkova
Almazov National Medical Research Centre
Author for correspondence.
Email: nadya.cvetkova@mail.ru
ORCID iD: 0000-0001-5751-6604
SPIN-code: 6788-0164
Clinical Resident
Saint PetersburgReferences
- Chouliaras G, Berdoukas V, Ladis V, et al. Impact of magnetic resonance imaging on cardiac mortality in thalassemia major. J Magn Reson Imaging. 2011;34(1):56–59. doi: https://doi.org/10.1002/jmri.22621
- Golfeyz S, Lewis S, Weisberg IS. Hemochromatosis: pathophysiology, evaluation, and management of hepatic iron overload with a focus on MRI. Expert Rev Gastroenterol Hepatol. 2018;12(8):767–778. doi: https://doi.org/10.1080/17474124.2018.1496016
- Gandon Y, Olivié D, Guyader D, et al. Non-invasive assessment of hepatic iron stores by MRI. Lancet. 2004;363(9406):357–362. doi: https://doi.org/10.1016/S0140-6736(04)15436-6
- St Pierre TG, Clark PR, Chua-anusorn W, et al. Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance. Blood. 2005;105(2):855–861. doi: https://doi.org/10.1182/blood-2004-01-0177
- Anderson LJ, Holden S, Davis B, et al. Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload. Eur Heart J. 2001;22(23):2171–2179. doi: https://doi.org/.1053/euhj.2001.2822
- Carpenter JP, He T, Kirk P, et al. On T2* magnetic resonance and cardiac iron. Circulation. 2011;123(14):1519–1528. doi: https://doi.org/10.1161/CIRCULATIONAHA.110.007641
- Garbowski MW, Carpenter JP, Smith G, et al. Biopsy-based calibration of T2* magnetic resonance for estimation of liver iron concentration and comparison with R2 Ferriscan. J Cardiovasc Magn Reson. 2014;16(1):40. doi: https://doi.org/10.1186/1532-429X-16-40
- Chandarana H, Lim RP, Jensen JH, et al. Hepatic iron deposition in patients with liver disease: preliminary experience with breath-hold multiecho T2*-weighted sequence. AJR Am J Roentgenol. 2009;193(5):1261–1267. doi: https://doi.org/10.2214/AJR.08.1996
- Westphalen AC, Qayyum A, Yeh BM, et al. Liver fat: effect of hepatic iron deposition on evaluation with opposed-phase MR imaging. Radiology. 2007;242(2):450–455. doi: https://doi.org/10.1148/radiol.2422052024
- Carpenter JP, Grasso AE, Porter JB, et al. On myocardial siderosis and left ventricular dysfunction in hemochromatosis. J Cardiovasc Magn Reson. 2013;15(1):24. doi: https://doi.org/10.1186/1532-429X-15-24
- Gulati V, Harikrishnan P, Palaniswamy C, et al. Cardiac involvement in hemochromatosis. Cardiol Rev. 2014;22(2):56–68. doi: https://doi.org/10.1097/CRD.0b013e3182a67805
- Majd Z, Haghpanah S, Ajami GH, et al. Serum Ferritin Levels Correlation With Heart and Liver MRI and LIC in Patients With Transfusion-Dependent Thalassemia. Iran Red Crescent Med J. 2015;17(4):e24959. doi: https://doi.org/10.5812/ircmj.17(4)2015.24959
- Mandal S, Sodhi KS, Bansal D, et al. MRI for Quantification of Liver and Cardiac Iron in Thalassemia Major Patients: Pilot Study in Indian Population. Indian J Pediatr. 2017;84(4):276–282. doi: https://doi.org/10.1007/s12098-017-2310-8
- Killick SB, Bown N, Cavenagh J, et al. Guidelines for the diagnosis and management of adult aplastic anaemia. Br J Haematol. 2016;172(2):187–207. doi: https://doi.org/10.1111/bjh.13853
- Porter J, Galanello R, Saglio G, et al. Relative response of patients with myelodysplastic syndromes and other transfusion-dependent anaemias to deferasirox (ICL670): a 1-yr prospective study. Eur J Haematol. 2008;80(2):168–176. doi: https://doi.org/10.1111/j.1600-0609.2007.00985.x
- Zhang Q, Hou B, Wang L, et al. [Significance of magnetic resonance imaging in the detection of iron overload]. Zhonghua Yi Xue Za Zhi. 2013;93(44):3506–3509.
Supplementary files
