T2* Magnetic Resonance Imaging Study of Pancreatic Iron Overload and its Relation With the Diabetic State in Thalassemic Patients

Abstract

The present study was performed to evaluate pancreatic hemosiderosis by means of magnetic resonance imaging (MRI) T2* and its relation to the diabetic state in thalassemic patients. One hundred thirty transfusion-dependent thalassemic patients from Zafar adult thalassemia clinic, Tehran, Iran, were enrolled in the study. Data such as age, type of thalassemia, age at diagnosis, transfusion duration, ferritin level, and fasting blood sugar results were gathered. Pancreatic MRI T2* was performed for all patients. One hundred four thalassemic patients with no sign of diabetes mellitus and 26 thalassemic patients with diabetes mellitus entered the study. Out of a total of 130 patients, 102 had pancreatic hemosiderosis. Among them, 23 of 26 diabetic patients (88.5%) and 79 of 104 nondiabetic patients (76%) showed pancreatic hemosiderosis, indicating no statistically significant difference between the 2 groups. The mean pancreatic MRI T2* relaxation time for all patients was 13.99±12.43 ms. The mean relaxation was 13.62±8.38 and 14.08±13.28 ms for diabetic and nondiabetic patients, respectively, showing no statistical difference (P=0.202). In conclusion, we did not find a significant difference between diabetic and nondiabetic thalassemic patients regarding the MRI T2* relaxation time readings or the rate of pancreatic hemosiderosis. We recommend performing studies with a higher sample size and including patients from different age groups to further evaluate the role of T2* MRI of pancreatic iron overload and its relation with the diabetic state in thalassemic patients.

The Evaluation of Renal Iron Deposition With a 3 Tesla MRI Device in Beta-Thalassemia Major Patients

“…However, in our study and that of ElAlfy et al [16], a statistically significant difference was shown in renal T2* time between the healthy control group and beta-thalassemia patients. There was no significant association between age and renal T2* time in our study, which is consistent with the literature [16,22].…”

“…ElAlfy et al [16] showed a weak correlation between renal R2* time and LIC value and a moderate negative correlation with cardiac T2* time. Hashemieh et al [22] showed a weak correlation between renal T2* time and liver and also cardiac T2* time. While Hashemieh et al revealed a weak correlation between ferritin and renal T2* time, ElAlfy et al [16] could not find any correlation at all.…”

Investigation of Pancreatic Sonography Findings in Patients With Beta-Thalassemia Major

“…Both echogenicity and glandular size reduction were significantly associated with transfusion treatment time. 28,29 The findings of the present study demonstrated that in this cohort, there was a weak association between pancreatic head size and serum ferritin levels. This may provide some lower-level evidence that patients with higher serum ferritin levels may have an enlarged pancreatic head.…”

Quantitative Magnetic Resonance Imaging for the Pancreas

“…22 Nonetheless, studies have yielded contradictory findings with regard to the link between pancreatic T2* or R2* value and glucose metabolism. [23][24][25][26][27][28] Some studies supported the usefulness of pancreatic T2* or R2* value for the identification of patients with glucose dysregulation, 23,24,26 whereas others did not report such correlation. 25,27,28 Intense periductal lymphoplasmacytic infiltration with interstitial fibrosis is the primary characteristic of autoimmune pancreatitis (a type of chronic pancreatitis), leading to mass-like swelling of the pancreas.…”