Iron Load Evaluation of Adrenal Glands and Kidneys by using MRI T۲* In Iranian Thalassemia Patients

Introduction: Multi-organ iron load is prevalent crucial side effect in thalassemic patients due to repeated transfusions, and high intestinal iron absorption. MRI T۲* has demonstrated its potency as a non-invasive technique for the imaging of hemosiderosis in thalassemia. We aim to investigate the iron load of adrenal glands and kidneys using MRI T۲* in adult thalassemia patients and evaluate the serum ferritin correlation of with kidneys, heart, liver, and adrenal glands’ iron load.Methods: Thirty-five thalassemia major (TM) and thalassemia intermediate (TI) patients (age range ۱۸-۵۰ years) from Zafar thalassemia Clinic, were recruited in this survey from September ۲۰۱۹ to October ۲۰۲۰. Magnetic Resonance Imaging (MRI) was used to map iron overload in several organs’ regions of interest (ROIs) using fast-gradient-echo multi echo T۲*sequences protocol. T-test and chi-square analysis were done.Results: Nine (۲۵.۷%) patients had left Kidney T۲* less than ۳۶ms which could indicate abnormal renal iron load while this was ۸ (۲۲.۹%) for the right kidney. In the left and right adrenal glands, these numbers were ۳۱ (۸۸.۶%) and ۲۹ (۸۲.۹%), respectively, below the normal threshold.Conclusion: Adrenal gland and renal iron overloads were detected in MRI images of thalassemic patients. Correlation for serum ferritin levels and kidney and adrenal glands T۲* was found weakly negative. Non-invasive monitoring of the internal organs’ hemosiderosis using MRI T۲* was found to be beneficial for iron-chelating optimization and preventing irreversible tissue damage.

Keywords:

magnetic resonance imaging , Iron overload , Thalassemia , Kidney , Adrenal glands