Spoiled Gradient Echo T2* iron-loading measurements of the liver and myocardium in 12 year old male with severely reduce
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Spoiled Gradient Echo T2* iron-loading measurements of the liver and myocardium in 12 year old male with severely reduced cardiac function from Thalassemia Major Annette L Dahl* and Taigang He Address: The Royal Brompton Hospital, London, UK * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):T3
doi:10.1186/1532-429X-12-S1-T3
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-12-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/T3 © 2010 Dahl and He; licensee BioMed Central Ltd.
Introduction Beta-Thalassemia Major affects 60.000 births per annum world-wide, and a further 94 million carriers. Mutations in the β-globin gene results in severe anaemia, leaving patients dependent on blood transfusions throughout their life. Excessive absorption combined with transfusional haemosiderosis cause iron-overload in the myocardium and liver. There is a 50% mortality rate in BetaTalassemia Major patients before the age of 35 due to iron overload, with cardiac failure being the main cause of death.
Purpose We report a 12 year old male with beta-Thalassemia Major, who was . Patient was treated with desferrioxamine chelation, . The patient hadbut with poor chelation compliance history, and therefore required urgent iron assessment of liver and myocardium.
Methods Cardiovascular Magnetic Resonance (CMR) scan including True-FISP volume measurements of cardiac function was performed on a 1.5T Siemens Symphony scanner. Iron-loading was assessed by using Spoiled Gradient Echo T2* sequence with high bandwidth of 810 Hz/pixel, TR 100ms and TE of 2.6-16.74ms (cardiac) and 0.93-16ms (hepatic).
The iron loading is measured by measuring the signal intensity for each image using a purpose-designed software programme (Thalassemia Tools) which subtracts the background noise from the myocardial/hepatic signal intensity, and plotting the signal intensitythe net value against the echo time to form an exponential decay curve. To derive T2*, an exponential trend-line is fitted with the following equation: Y= Ke -TE/T2* K represents a constant, TE= Echo Time and Y =image signal intensity. The later low signal to noise ratio (SNR) data points were discarded to address issues of noise and artefacts.
Results T2* measurements of liver demonstrated severe hepatic iron loading of 1.3ms, T2* measurements of myocardium demonstrated moderate cardiac iron loading of 15.2ms and volumetric measurements on True-FISP cine sequences concluded severely dilated left ventricle with severe systolic dysfunction and left ventricular ejection fraction of 28%.
Conclusions T2* MRI can be successfully used along with CMR for assessment of cardiac function along with myocardial
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