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

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.

[1]  G. Adam,et al.  Pancreatic iron and fat assessment by MRI‐R2* in patients with iron overload diseases , 2015, Journal of magnetic resonance imaging : JMRI.

[2]  Meng-Ju Li,et al.  Diabetes mellitus in patients with thalassemia major , 2014, Pediatric blood & cancer.

[3]  M. Yaseri,et al.  Relation between serum ferritin and liver and heart MRI T2* in beta thalassaemia major patients. , 2013, Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit.

[4]  V. De Sanctis,et al.  Iron overload and glucose metabolism in subjects with β-thalassaemia major: an overview. , 2013, Current diabetes reviews.

[5]  D. Youssef,et al.  Assessment of Hepatic and Pancreatic Iron Overload in Pediatric Beta-Thalassemic Major Patients by T2* Weighted Gradient Echo Magnetic Resonance Imaging , 2013, ISRN hematology.

[6]  A. Araújo,et al.  Pancreatic iron stores assessed by magnetic resonance imaging (MRI) in beta thalassemic patients. , 2012, European journal of radiology.

[7]  R. Watanabe,et al.  Pancreatic iron and glucose dysregulation in thalassemia major , 2012, American journal of hematology.

[8]  K. E. Allam,et al.  Gradient-echo magnetic resonance imaging study of pancreatic iron overload in young Egyptian beta-thalassemia major patients and effect of splenectomy , 2010, Diabetology & metabolic syndrome.

[9]  A. Ogbera,et al.  Prevalence and gender distribution of the metabolic syndrome , 2010, Diabetology & metabolic syndrome.

[10]  S. Rivella Ineffective erythropoiesis and thalassemias , 2009, Current opinion in hematology.

[11]  I. Youssry,et al.  Abnormal Glucose Tolerance in β-Thalassemia: Assessment of Risk Factors , 2009, Hemoglobin.

[12]  W. Au,et al.  A cross-sectional magnetic resonance imaging assessment of organ specific hemosiderosis in 180 thalassemia major patients in Hong Kong , 2008, Haematologica.

[13]  W. Au,et al.  A T2* magnetic resonance imaging study of pancreatic iron overload in thalassemia major , 2008, Haematologica.

[14]  L. Astrakas,et al.  Liver, bone marrow, pancreas and pituitary gland iron overload in young and adult thalassemic patients: a T2 relaxometry study , 2007, European Radiology.

[15]  John C Wood,et al.  Magnetic resonance imaging measurement of iron overload , 2007, Current opinion in hematology.

[16]  N. Gourtsoyiannis,et al.  The pancreas in beta-thalassemia major: MR imaging features and correlation with iron stores and glucose disturbances. , 2007, European radiology.

[17]  N. Gourtsoyiannis,et al.  The pancreas in β-thalassemia major: MR imaging features and correlation with iron stores and glucose disturbunces , 2007, European Radiology.

[18]  E. Gotsis,et al.  Effect of enhanced iron chelation therapy on glucose metabolism in patients with β‐thalassaemia major , 2006, British journal of haematology.

[19]  A. Cnaan,et al.  Survival and Complications in Thalassemia , 2005, Annals of the New York Academy of Sciences.

[20]  C. Kattamis,et al.  Evolution of glucose intolerance and diabetes in transfused patients with thalassemia. , 2004, Pediatric endocrinology reviews : PER.

[21]  A. Khalifa,et al.  Abnormal glucose tolerance in Egyptian beta‐thalassemic patients: possible association with genotyping , 2004, Pediatric diabetes.

[22]  J. D. Johnston Non-invasive assessment of hepatic iron stores by MRI. , 2004, Annals of clinical biochemistry.

[23]  D. Pennell,et al.  A single breath‐hold multiecho T2* cardiovascular magnetic resonance technique for diagnosis of myocardial iron overload , 2003, Journal of magnetic resonance imaging : JMRI.

[24]  Meng-Yao Lu,et al.  Abnormal Glucose Tolerance in Transfusion-Dependent β-Thalassemic Patients , 2001 .

[25]  S. Pinach,et al.  The possible role of autoimmunity in the pathogenesis of diabetes in B-thalassemia major. , 2001, Diabetes & metabolism.

[26]  D. Lin,et al.  Abnormal glucose tolerance in transfusion-dependent beta-thalassemic patients. , 2001, Diabetes care.

[27]  A. Bouloukos,et al.  Ultrasonography of the Pancreas, as a Function Index, in Children with β-Thalassemia , 2000, Journal of pediatric endocrinology & metabolism : JPEM.

[28]  M. Cappellini,et al.  Thalassaemia International Federation , 1990, The Lancet.