Abdominal Lymphadenopathy in β-Thalassemia: MRI Features and Correlation with Liver Iron Overload and Posttransfusion Chronic Hepatitis C

Abstract

The development of hypointense abdominal lymphadenopathy in patients with beta-thalassemia major who have received multiple transfusions depends both on the severity of liver iron overload and on the presence and the activity level of coexistent chronic hepatitis C.

The pancreas in β-thalassemia major: MR imaging features and correlation with iron stores and glucose disturbunces

“…We considered P/M values in the inphase images as indicative of pancreatic siderosis although P/M are expected to be somewhat affected by fatty replacement, particularly on the T1 GRE images; however, on the intermediate weighted in-phase images and, mainly, on the T2*-weighted images the impact of fat on the pancreatic signal is not particularly significant as the strong paramagnetic effect of the stored iron predominates. Recent studies have documented that iron deposition in myocardium and pituitary cannot be predicted by the degree of hepatic siderosis [14,15,35], whereas iron deposition in the adrenals and abdominal lymph nodes seems to relate with the severity of hepatic siderosis [26,36]. These observations may reflect differences in iron kinetics between various tissues; MR imaging can provide a new insight in the distribution of iron in human body.…”

“…All sequences were obtained in the axial plane, with slice thickness 8-10 mm, image matrix 256*192, and a field of view of 400-500 mm. These MR imaging studies aimed, originally, at the non-invasive evaluation of liver siderosis; the MR imaging protocol was based on literature data [9,10,26] as well as trials with phantoms and equation fits between liver iron concentration in liver biopsy specimens (TM, OP unpublished data).…”

Bone marrow changes in beta-thalassemia major: quantitative MR imaging findings and correlation with iron stores

“…The degree of signal reduction caused by superparamagnetic iron oxides (SPIO) is different between liver, spleen and bone marrow, due to differences in clustering of SPIO particles between RE cells [36][37][38]. It has been also documented that hepatic siderosis assessed by MR imaging relates to the amount of iron in the adrenals and abdominal lymph nodes [13,14], but not in the pituitary gland and myocardium [11,39]. These observations support the possible presence of different mechanisms of iron uptake and removal between various tissues and organs.…”

“…Another limitation is the lack of biopsies due to ethical reasons. However, MR imaging is considered accurate for iron quantification [8][9][10][11][12][13][14][15][16][17][18] even more than biopsy, due to the examining of the entire organ and the selecting of ROIs of larger tissue volume [8,33]. Another limitation is that iron concentration in the paraspinous muscles potentially depends on the degree of iron overload.…”

“…Serum ferritin level can be misleading, as it is influenced by several conditions [4]. MR imaging is considered a very accurate method for detecting iron deposition in various tissues, due to the strong paramagnetic properties of intracellular ferritin and hemosiderin that cause T2 relaxation time shortening and signal intensity (SI) reduction in spin echo (SE) and gradient echo (GRE) sequences [5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”