Bone marrow changes in beta-thalassemia major: quantitative MR imaging findings and correlation with iron stores |
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Authors: | Eleni E Drakonaki Thomas G Maris Alex Papadakis Apostolos H Karantanas |
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Institution: | (1) Radiology Department, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece;(2) Department of Medical Physics, University of Crete, 711 10 Heraklion, Crete, Greece;(3) Venizelion General Hospital, Knossou Avenue, 71409 Heraklion, Crete, Greece |
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Abstract: | The purpose of this study is to describe the MR imaging features of bone marrow in beta-thalassemia major and investigate
their relation to ferritin, liver and spleen siderosis. Spinal bone marrow was prospectively assessed on abdominal MR studies
of 40 transfused beta-thalassemic patients and 15 controls using T1-w, Pd, T2*-w Gradient Echo (GRE) and T1-w turbo Spin Echo
(TSE) sequences. Signal intensity (SI) ratios of liver, spleen and bone marrow to paraspinous muscles (L/M, S/M, B/M respectively)
and the respective T2 relaxation rates (1/T2) were calculated. Serum ferritin levels were recorded. Bone marrow hypointensity
in at least T2*-w GRE sequence was noted in 29/40 (72.5%) patients. Eleven/40 patients exhibited normal B/M on all MR sequences.
Five/40 patients had normal B/M and low L/M. B/M correlated with L/M in T1-w TSE sequence only (r = 0.471, p = 0.05). B/M correlated with S/M and mean ferritin values in all sequences (r > 0.489, p < 0.01 and r > − 0.496, p < 0.03 respectively). Marrow 1/T2 did not correlate with ferritin values or liver and spleen 1/T2. B/M in transfused beta-thalassemic
patients is related to splenic siderosis and ferritin levels. Although marrow is usually hypointense, it may occasionally
display normal SI coexisting with liver hypointensity, a pattern typical of primary hemochromatosis. |
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Keywords: | Bone marrow Iron MR imaging Thalassemia |
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