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

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

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.

Full Text

Restricted Access

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 Petersburg

Vladimir 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 Petersburg

Gennadii 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 Petersburg

Ksenia S. Shalygina

Almazov National Medical Research Centre

Email: shalygina_k98@mail.ru
ORCID iD: 0000-0001-5000-3582

Clinical Resident

Russian Federation, Saint Petersburg

Nadezhda 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 Petersburg

References

  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. 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

Supplementary Files
Action
1. Fig. 1

Download (115KB)
2. Fig. 2

Download (353KB)
3. Fig. 3

Download (254KB)
4. Fig. 4

Download (259KB)

Copyright (c) 2023 "Paediatrician" Publishers LLC



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies