Lidén Mats, Adrian David, Widell Jonas, Uggla Bertil, Thunberg Per
Department of Radiology, Faculty of Medicine and Health, Örebro University, S-701 82, Sweden.
Department of Radiology, Örebro University Hospital, Region Örebro County, Sweden.
Eur J Radiol Open. 2021 May 24;8:100357. doi: 10.1016/j.ejro.2021.100357. eCollection 2021.
Patients with transfusion dependent anemia are at risk of complications from iron overload. Quantitative T2* magnetic resonance imaging (MRI) is the best non-invasive method to assess iron deposition in the liver and heart and to guide chelation therapy.
To investigate the image quality and inter-observer variations in T2* measurements of the myocardium and the liver, and to obtain the lower limit of cardiac and hepatic quantitative T2* values in patients without suspicion of iron overload.
Thirty-eight patients referred for cardiac MRI were prospectively included in the study. Three patients were referred with, and 35 without suspicion of iron overload. Quantitative T2* parametric maps were obtained on a 1.5 T MRI system in the cardiac short axis and liver axial view. Two readers independently assessed the image quality and the representative and the lowest T2* value in the myocardium and the liver.
The normal range of representative T2* values in the myocardium and liver was 24-45 ms and 14-37 ms, respectively. None of the 35 participants (0 %, 95 % confidence interval 0-11 %) in the normal reference group demonstrated representative T2* values below previously reported lower limits in the myocardium (20 ms) or the liver (8 ms). Focal myocardial areas with T2* values near the lower normal range, 19-20 ms, were seen in two patients. The readers generally reported good image quality.
T2* imaging for assessing iron overload can be performed in a non-dedicated center with sufficient image quality.
依赖输血的贫血患者存在铁过载并发症的风险。定量T2*磁共振成像（MRI）是评估肝脏和心脏中铁沉积以及指导螯合治疗的最佳非侵入性方法。
研究心肌和肝脏T2测量的图像质量及观察者间差异，并获取无铁过载怀疑患者心脏和肝脏定量T2值的下限。
前瞻性纳入38例因心脏MRI检查而转诊的患者。其中3例患者有铁过载怀疑，35例无铁过载怀疑。在1.5 T MRI系统上获取心脏短轴和肝脏轴位的定量T2参数图。两名阅片者独立评估图像质量以及心肌和肝脏中的代表性T2值和最低T2*值。
心肌和肝脏中代表性T2值的正常范围分别为24 - 45 ms和14 - 37 ms。正常参考组的35名参与者中无一例（0%，95%置信区间0 - 11%）的代表性T2值低于先前报道的心肌（20 ms）或肝脏（8 ms）下限。两名患者出现T2*值接近正常范围下限（19 - 20 ms）的局灶性心肌区域。阅片者普遍报告图像质量良好。
用于评估铁过载的T2*成像可在非专门中心进行，且图像质量足够。
