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Subject Area

Radiology and Imaging Sciences

Article Type

Original Study

Abstract

Background Thalassemia is a hereditary hemolytic blood disorder that results in abnormal form or inadequate amounts of one of the two globin chains, which are the building blocks of the hemoglobin structure, thus causing anemia, which is mainly treated by blood transfusions, with resultant increased tissue iron overload, which could be assessed noninvasively by MRI. Objectives To evaluate the role of MRI in assessment of pancreatic and hepatic iron overload in patients with β-thalassemia major using transverse relaxation time/gradient-echo imaging sequences, signal intensity ratio, and relaxometry. Patients and methods A prospective study included 25 patients with β-thalassemia major recruited from the hematology clinic, Menoufia University, from September 2018 to September 2019. Results There is remarkably lower signal intensity ratio of the pancreas and the liver in thalassemic patients, both of which have been also strongly correlated with each other (P = 0.002). Thalassemic patients with abnormal glucose tolerance featured a higher proportion of pancreatic hemosiderosis compared with normoglycemic thalassemic patients (P < 0.001). Splenectomized patients have notably increased hepatic and pancreatic iron overload (P = 0.002) than nonsplenectomized patients. Serum ferritin values were also positively correlated with the levels of both hepatic and pancreatic iron overload, especially accentuated in patients having diabetes/impaired glucose tolerance (Spearman's rank correlation coefficient analysis = 0.772, P > 0.001). Conclusions Pancreatic and hepatic hemosiderosis could be reliably detected by transverse relaxation time/gradient-echo MRI in thalassemic patients; this was more pronounced with disturbed glucose tolerance. Moreover, it was found that splenectomy may accelerate parenchymal tissue iron deposition.

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