Meloni Antonella, Pistoia Laura, Garamella Davide, Parlato Alessandro, Positano Vincenzo, Ricchi Paolo, Casini Tommaso, De Marco Emanuela, Corigliano Elisabetta, Borsellino Zelia, Visceglie Domenico, De Caterina Raffaele, Pepe Alessia, Cademartiri Filippo
Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.
J Magn Reson Imaging. 2025 Apr;61(4):1650-1661. doi: 10.1002/jmri.29625. Epub 2024 Oct 3.
No study has assessed myocardial T1 and T2 values in patients with beta-thalassemia intermedia (β-TI).
To assess the prevalence of myocardial involvement in β-TI patients by T2* relaxometry and native T1 and T2 mapping and to determine the correlation of myocardial relaxation times with demographic and clinical parameters.
Prospective matched-cohort study.
42 β-TI patients (27 females, 39.65 ± 12.32 years), enrolled in the Extension-Myocardial Iron Overload in Thalassaemia Network, and 42 age- and sex-matched healthy volunteers (27 females, 40.01 ± 11.36 years) and thalassemia major (TM) patients (27 females, 39.27 ± 11.57 years).
FIELD STRENGTH/SEQUENCE: 1.5 T/multi-echo gradient echo, modified Look-Locker inversion recovery, multi-echo fast-spin-echo, cine balanced steady-state-free precession, and late gadolinium enhancement (LGE) sequences.
Hepatic, pancreatic, and left ventricular (LV) T2* values, LV native T1 and T2 values, biventricular ejection fractions and volumes, and presence and extent of replacement myocardial fibrosis.
Comparisons between two groups were performed with two-sample t tests, Wilcoxon's signed rank tests, or χ testing. Correlation analysis was performed using Pearson's or Spearman's test. P < 0.05 was considered statistically significant.
β-TI patients had significantly higher LV T2 values than healthy subjects (56.84 ± 4.03 vs. 52.46 ± 2.50 msec, P < 0.0001) and significantly higher LV T1 values than TM patients (1018.32 ± 48.94 vs. 966.66 ± 66.47 msec, P < 0.0001). In β-TI, female gender was associated with significantly increased LV T1 (P = 0.041) and T2 values (P < 0.0001), while splenectomy and presence of regular transfusions were associated with significantly lower LV T1 values (P = 0.014 and P = 0.001, respectively). In β-TI patients, all LV relaxation times were significantly correlated with each other (T2*-T1: P = 0.003; T2*-T2: P = 0.003; T1-T2: P < 0.0001). Two patients with a reduced LV T2* also had a reduced LV T1, while only one had a reduced LV T2. Three patients had a reduced LV T1 but a normal LV T2*; 66.7% of the patients had an increased LV T2. All LV relaxation times were significantly correlated with pancreas T2* values (T2*: P = 0.033; T1: P < 0.0001; T2: P = 0.014). No LV relaxation time was associated (P > 0.05) with hepatic iron concentration, biventricular function parameters, or LGE presence.
The combined use of all three myocardial relaxation times has potential to improve sensitivity in the detection of early/subclinical myocardial involvement in β-Tl patients.
2 TECHNICAL EFFICACY: Stage 2.
尚无研究评估中间型β地中海贫血（β-TI）患者的心肌T1和T2值。
通过T2*弛豫测量法、心肌固有T1和T2成像评估β-TI患者心肌受累的患病率，并确定心肌弛豫时间与人口统计学和临床参数之间的相关性。
前瞻性匹配队列研究。
42例β-TI患者（27例女性，年龄39.65±12.32岁），纳入地中海贫血网络心肌铁过载扩展研究，以及42例年龄和性别匹配的健康志愿者（27例女性，年龄40.01±11.36岁）和重型地中海贫血（TM）患者（27例女性，年龄39.27±11.57岁）。
场强/序列：1.5T/多回波梯度回波序列、改良Look-Locker反转恢复序列、多回波快速自旋回波序列、电影稳态自由进动序列和延迟钆增强（LGE）序列。
肝脏、胰腺和左心室（LV）的T2*值、LV心肌固有T1和T2值、双心室射血分数和容积，以及替代性心肌纤维化的存在情况和范围。
两组之间的比较采用双样本t检验、Wilcoxon符号秩检验或χ检验。相关性分析采用Pearson检验或Spearman检验。P<0.05被认为具有统计学意义。
β-TI患者的LV T2值显著高于健康受试者（56.84±4.03 vs. 52.46±2.50毫秒，P<0.0001），LV T1值显著高于TM患者（1018.32±48.94 vs. 966.66±66.47毫秒，P<0.0001）。在β-TI患者中，女性与LV T1（P=0.041）和T2值（P<0.0001）显著升高相关，而脾切除术和定期输血与LV T1值显著降低相关（分别为P=0.014和P=0.001）。在β-TI患者中，所有LV弛豫时间之间均显著相关（T2*-T1：P=0.003；T2*-T2：P=0.003；T1-T2：P<0.0001）。2例LV T2降低的患者LV T1也降低，而只有1例LV T2降低。3例患者LV T1降低但LV T2正常；66.7%的患者LV T2升高。所有LV弛豫时间均与胰腺T2值显著相关（T2：P=0.033；T1：P<0.0001；T2：P=0.014）。没有LV弛豫时间与肝脏铁浓度、双心室功能参数或LGE的存在相关（P>0.05）。
联合使用所有三种心肌弛豫时间有可能提高检测β-TI患者早期/亚临床心肌受累的敏感性。
2 技术效能：2级
