Cardiac T2∗ magnetic resonance analysis of membranous interventricular septum in assessment of cardiac iron overload in pediatric thalassemia patients: A pilot study

Abstract

Background: Cardiac iron deposition in transfusion-dependent thalassemia patients is patchy in distribution. Purpose: The purpose of this study is to assess the correlation between T2∗ matrices of membranous interventricular septum (MIVS) and T2∗ values of muscular interventricular septum (IVS) on magnetic resonance imaging (MRI) and to evaluate the relationship of myocardial T2∗ at these two locations with MRI-estimated liver iron concentrations (LIC) and electrocardiographic (ECG) parameters. Material and Methods: MRI of heart and liver was performed in 16 consecutive pediatric patients of transfusion-dependent thalassemia major to calculate liver iron concentration and T2∗ time of membranous and muscular IVS. ECG parameters of these patients were charted and correlated with MRI parameters. Results: No significant correlation between T2∗ values of muscular IVS and MIVS was observed. Mean T2∗ of MIVS (9.8 ms) was significantly lower than that of muscular IVS (26.9 ms). T2∗ of MIVS correlated strongly with LIC where as a weak correlation was observed between T2∗ of IVS and LIC. Significantly higher mean QTc (corrected QT interval) value (439.86 ms) was seen in patients with T2∗ IVS <20 ms. Conclusion: Addition of T2∗ analysis of MIVS to the existing MRI protocol, consisting of muscular IVS analysis, may offer a more sensitive estimation of cardiac iron overload. © 2019 Indian Journal of Radiology and Imaging | Published by Wolters Kluwer - Medknow.