MRI monitoring of myocardial iron overload: use of cardiac MRI combined with hepatic MRI in a cohort of multi-transfused patients with thalassaemia.

Abstract

We report the results of combining cardiac and hepatic MRI in the same examination to monitor 48 multi-transfused patients presenting iron overload secondary to their transfusions. This cardiac MRI technique uses acquisition sequences and calculation software that are readily available for 1.5 T systems, and it has been validated to screen for patients at risk of cardiac complications who present myocardial iron overload (T2*<20milliseconds). A total of 176 combined MRI examinations were performed between May 2006 and January 2012 in 48 patients who had received transfusions due to thalassaemia. This monocentric retrospective study brings together all of the imaging examinations carried out. There was a positive correlation between the cardiac T2* values and left ventricular ejection fraction, which were measured in the same examination. At the first assessment 23/48 patients had a T2*<20ms. These patients showed a significant improvement in cardiac T2* over time while their iron chelation therapy was being intensified. This study validates the application of the cardiac MRI technique used to monitor cardiac iron overload in patients who have undergone multiple transfusions.