Does T2* MRI analysis of the membranous interventricular septum provide a more sensitive estimation of cardiac iron overload compared to the muscular interventricular septum in pediatric thalassemia patients?
Addition of T2* analysis of the membranous interventricular septum to standard MRI protocols may offer a more sensitive estimation of cardiac iron overload in pediatric thalassemia patients.
BACKGROUND: Cardiac iron deposition in transfusion-dependent thalassemia patients is patchy in distribution. PURPOSE: The purpose of this study is to assess the correlation between T2* matrices of membranous interventricular septum (MIVS) and T2* values of muscular interventricular septum (IVS) on magnetic resonance imaging (MRI) and to evaluate the relationship of myocardial T2* at these two locations with MRI-estimated liver iron concentrations (LIC) and electrocardiographic (ECG) parameters. MATERIAL AND METHODS: MRI of heart and liver was performed in 16 consecutive pediatric patients of transfusion-dependent thalassemia major to calculate liver iron concentration and T2* time of membranous and muscular IVS. ECG parameters of these patients were charted and correlated with MRI parameters. RESULTS: No significant correlation between T2* values of muscular IVS and MIVS was observed. Mean T2* of MIVS (9.8 ms) was significantly lower than that of muscular IVS (26.9 ms). T2* of MIVS correlated strongly with LIC where as a weak correlation was observed between T2* of IVS and LIC. Significantly higher mean QTc (corrected QT interval) value (439.86 ms) was seen in patients with T2* IVS <20 ms. CONCLUSION: Addition of T2* analysis of MIVS to the existing MRI protocol, consisting of muscular IVS analysis, may offer a more sensitive estimation of cardiac iron overload.
Kumar et al. (Tue,) studied this question.