MRI Evaluation of Liver Iron Concentration in Patients with β-Thalassemia Major

β major is a hereditary anemia, characterized by a genetic deficiency in the synthesis of the β-globin chain (1). The main complication of the multiple blood transfusions to these patients is iron overload and the deposition of iron in various organs, such as the reticuloendothelial system, the liver, the heart and the endocrine glands (2). Chelators also have various side effects on multiple organs in thalassemic patients, besides iron overload. Deferoxamin (DFO) which is the chelating agent most widely used for the last 30 years, mainly affects the optic, auditory and skeletal systems (3). The effective management of thalassemic patients, especially children, requires monitoring of the toxic effects of iron overload versus chelation therapy. The most reliable method of calculating body iron stores is the biochemical or histochemical assessment of iron in a liver biopsy specimen. Since liver biopsy is an invasive procedure, attempts have been made to use imaging for detection and quantification of liver iron content (4-7). Magnetic resonance imaging (MRI) is a technique for the diagnosis of hemochromatosis. Many investigators have shown that hepatic T2 relaxation or intensity ratios in MR images have a significant correlation with hepatic iron content (8-11). In this study, we have evaluated the correlation of the hemochromatosis grades in liver MRIs and liver biopsies to evaluate the precision of liver MRIs in grading hemochromatosis. This double-blind crosssectional study was conducted between January 2007 and April 2008 at the Hematology Research Center, Shiraz University of Medical Sciences. Twenty-eight blood transfusion-dependent thalassemia major patients were involved in this double-blind cross-sectional study. Thalassemia major was determined in these patients by a complete blood count (CBC) and hemoglobin electrophoresis. Patients were selected from a population that had had liver biopsies performed on them for various purposes. The exclusion criteria for this study were acute or chronic viral hepatitis and any kind of infection found in physical examinations. After obtaining the patients’ written informed