Rofo 2012; 184 - KMY09
DOI: 10.1055/s-0031-1300877

Distribution of Cardiac Iron measured by MRI-R2*

J Yamamura 1, B Schönnagel 1, R Grosse 1, G Adam 1, R Fischer 1
  • 1Universitätsklnikum Hamburg-Eppendorf, Diagnostische und Interventionelle Radiologie, Hamburg

Purpose:

To assess regional iron distribution by MRI-R2* within the heart of patients with b-thalassemia major (TM) and other iron overload diseases.

Materials and Methods:

Breathhold ECG gated MRI (1.5 T) of the heart was used for the measurement of transverse relaxation rates R2* in 32 patients (11–79 y). In a mid-papillary short-axis slice divided into septal, anterior, lateral, and posterior quadrants, R2* was analyzed from ROI based signal intensities from 12 echo times (TE=1.3–26ms). Typical boundary effects were evaluated in detail.

Results:

The segmentation of the cardiac wall resulted in highly significant correlations of R2* between septal and all other quadrants. In the patient group with R2* <50s-1 (normal), all quadrants show significantly higher median rates (126±25%, 150±24%, 174±51%) than the septum (p<10-4). Typical boundary effects on segmental R2* from blood, lung tissue, epicardial fat and hepatic iron could not be easily separated from segmental iron distribution.

Conclusion:

The measurement of MRI-R2* in the interventricular septum is representative for the cardiac wall and the least affected method by boundary effects to detect patients with iron overload at risk of developing heart failure.

Clinical Relevance:

When measuring the cardiac iron concentration with the MRI, the interventricular septum leads to the most sufficient quantification. A precise measurement is important for the medical treatment for these patients.