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Liver iron overload assessment by MRI R2* relaxometry in highly transfused pediatric patients: an agreement and

S Verlhac1, M Morel1, F Bernaudin2

  • 1Service d'imagerie médicale, centre de référence de la drépanocytose, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94010 Créteil cedex, France.

Diagnostic and Interventional Imaging
|December 24, 2014
PubMed
Abstract

Insights

R2* relaxometry accurately estimates liver iron in transfused children. This MRI technique offers excellent reproducibility and can be rapidly applied for assessing iron overload, aiding in managing pediatric patients with conditions like sickle cell disease.

Area of Science:

  • Medical Imaging
  • Pediatric Hematology
  • Radiology

Background:

  • Iron overload is a risk in children receiving frequent blood transfusions.
  • Accurate monitoring of liver iron concentration (LIC) is crucial for managing complications.
  • Current reference methods for LIC assessment can be invasive or less precise.

Purpose of the Study:

  • To compare R2* relaxometry with the liver/muscle signal intensity ratio (SIR) for estimating liver iron in transfused children.
  • To assess the agreement and reproducibility of R2* relaxometry in this pediatric population.

Main Methods:

  • Ninety-two MRI scans from 68 children, primarily with sickle cell disease, were analyzed.
  • R2* relaxometry was performed using a multiecho T2* sequence and compared to the SIR method.
  • Hepatic iron load was calculated using the Wood formula based on R2* values.

Main Results:

  • R2* relaxometry showed a very good correlation (Pearson's r=0.89) with the SIR method.
  • Inter- and intraobserver reproducibility for R2* relaxometry measurements were excellent.
  • A consistent overestimation of hepatic iron by SIR compared to R2* relaxometry was observed.

Conclusions:

  • Multiecho gradient-echo MRI sequences allow for rapid and precise estimation of hepatic iron content.
  • R2* relaxometry is a reliable and reproducible method for assessing iron overload in pediatric patients.
  • This technique can aid in the clinical management of iron overload in transfused children.
Keywords:
Iron overloadLiver MRISickle cell disease

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