Istituto di Fisiologia Clinica     
Positano V., Pepe A., Santarelli M. F., Ramazzotti A., Meloni A., De Marchi D., Favilli B., Cracolici E., Midiri M., Spasiano A., Lombardi M., Landini L. Multislice multiecho T2* cardiac magnetic resonance for the detection of heterogeneous myocardial iron distribution in thalassaemia patients. In: Nmr in Biomedicine, vol. 22 pp. 707 - 715. John Wiley & Sons, 2009.
The present study investigated myocardial T2* heterogeneity in thalassaemia major (TM) patients by cardiac magnetic resonance (CMR), to determine whether is related to inhomogeneous iron overload distribution. A total of 230 TM patients consecutively referred to our laboratory were studied retrospectively. Three short-axis views (basal, medium and apical) of the left ventricle (LV) were obtained by multislice multiecho T2* CMR. T2* segmental distribution was mapped on a 16-segment LV model. The level of heterogeneity of the T2* segmental distribution, evaluated by the coefficient of variation (CoV),was compared with that of a surrogate data set, to determinewhether the inhomogeneous segmental distribution of T2* could be generated by susceptibility artefacts. Susceptibility artefacts offer an explanation for the T2* heterogeneity observed in patientswithout iron overload. In subjectswith global T2* belowthe lower limit of the normal, T2* heterogeneity increased abruptly which could not be xplained by artefactual effects. Some segmental T2* values were below and others above the limit of normal threshold (20ms) in 104 (45%) TM patients. Among these patients, 74% showed a normal T2* global value. In conclusion, a true heterogeneity in the iron overload distribution may be present in TM patients. Heterogeneity seemingly appears in the borderline myocardial iron and stabilizes at moderate to severe iron burden.
URL: http://www3.interscience.wiley.com/journal/122276532/abstract?CRETRY=1&SRETRY=0
DOI: 10.1002/nbm.1382
Subject iron overload
cardiac MRI

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