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- Title
Pancreatic iron and fat assessment by MRI-R2* in patients with iron overload diseases.
- Authors
Pfeifer, Charlotte D.; Schoennagel, Bjoern P.; Grosse, Regine; Wang, Zhiyue J.; Graessner, Joachim; Nielsen, Peter; Adam, Gerhard; Fischer, Roland; Yamamura, Jin
- Abstract
Background To determine the pancreatic iron (R2*) and fat content (FC) in comparison to hepatic and cardiac R2* in patients with iron overload disorders like β-thalassemia major (TM), Diamond-Blackfan anemia (DBA) or hereditary hemochromatosis. Methods R2* rates were assessed in the liver, heart and pancreas of 42 patients with TM, 29 subjects with other iron overload diseases, and 10 controls using an ECG-gated breathhold sequence (12 echo time [TE] = 1.3-25.7 ms, readout repetition time [TR] = 244 ms). Pancreatic R2* and FC were assessed from TE dependent region of interest based signal intensities performing water−fat chemical shift relaxometry and were compared with laboratory parameters (glucose, HbA1c, amylase and lipase). Results A pancreatic iron gradient from tail (R2* = 122 s−1) to head (R2* = 114 s−1, P < 10−4) was found. The close association between cardiac and pancreatic R2* was also confirmed in patients with TM and other iron overload diseases (rs = 0.64, P < 10−4). Receiver operator characteristic analysis (area: 0.89, P < 10−4) identified patients with elevated cardiac iron at a pancreatic R2* cut-off level of 131s−1 (sensitivity = specificity at 81%). Highest pancreatic R2* (211s−1) and FC (36%) were found in the tail region of diabetic patients with TM. Conclusion Pancreatic tail showed highest R2* rates and fat contents, especially in patients with thalassemia. Besides iron accumulation fatty degeneration might be an additional risk factor for the development of diabetes in β-thalassemia major, but this hypothesis needs further studies in prediabetic patients. J. Magn. Reson. Imaging 2015;42:196-203. © 2014 Wiley Periodicals, Inc.
- Publication
Journal of Magnetic Resonance Imaging, 2015, Vol 42, Issue 1, p196
- ISSN
1053-1807
- Publication type
Article
- DOI
10.1002/jmri.24752