Quantification of liver iron overload by T2 quantitative magnetic resonance imaging in thalassemia: impact of chronic hepatitis C on measurements.
Papakonstantinou O, Kostaridou S, Maris T, Gouliamos A, Premetis E, Kouloulias V, Nakopoulou L, Kattamis C.: J Pediatr Hematol Oncol 1999 Mar-Apr;21(2):142-8
PURPOSE: Measurement of
liver T2 values seems to be an accurate and sensitive magnetic
resonance imaging (MRI) method for the quantification of liver
hemosiderosis in multiple transfused patients with thalassemia.
Because many of these patients have coexistent chronic hepatitis
C virus (HCV) infection, the effect of inflammatory changes on
liver T2 values was assessed. MATERIALS AND METHODS: Liver MRI
studies of 35 HCV+ and 17 HCV- patients with beta-thalassemia,
9 HCV+ patients without thalassemia, and 10 healthy controls of
the same age range (13 to 32 years) were reviewed. Iron status
was assessed by serum ferritin in all patients, and determination
of liver iron concentration (LIC) was available in 16 HCV+ patients
with thalassemia. Histologic activity index (HAI) and grades of
siderosis were evaluated in all HCV+ patients with thalassemia.
RESULTS: Patients with thalassemia had significantly lower T2
values (P < 0.0001) than subjects without thalassemia, whereas
no difference existed between HCV+ patients without thalassemia
and healthy controls. In HCV+ patients, LIC correlated more nearly
with T2 values (r = 0.93) than with serum ferritin (r = 0.73).
T2 values were not influenced by HAI score or fibrosis. CONCLUSION:
Liver T2 values were found to be more accurate than serum ferritin
in predicting liver iron overload and were not influenced by the
presence of chronic hepatitis C. Therefore, MRI could serve as
a noninvasive alternative to liver biopsy for the quantification
of hemosiderosis in HCV+ patients with thalassemia.
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