MRI for Quantitative Determination of Iron in the Liver and Heart in Patients with Primary and Secondary Hemochromatoses in Association with Serrum Ferritin: Single-Stage Observational Study

Abstract

Background. An extremely small number of studies have been devoted to the study of differences in LIC (liver iron concentration) and MIC (myocardium iron concentration) indicators, as well as their correlation with each other and with ferritin levels in patients with various nosological forms. Aims to study the relationship of ferritin, LIC and MIC levels in patients with various causes of hemochromatosis (hereditary hemochromatosis (HH), aplastic anemia (AA), primary myelofibrosis (PMF), thalassemia (TL), myelodysplastic syndrome (MDS)). Methods. The design of the study is a singlestage observational one. The study included 91 patients with primary hemochromatosis and secondary transfusion-dependent hemochromatosis receiving regular blood transfusion and iron chelate therapy from 2015 to 2018. The studies were carried out on 1.5 T MR-scanner Magnetom Espree (Siemens, Germany), and myocardial iron concentration (MIC) was calculated using the formula MIC = 45 (T2*) 1.22. Liver iron concentration (LIC) was calculated using the formula LIC = 0.03 R2* + 0.74. The ferritin level was determined by enzyme immunoassay. Statistical processing of the results obtained was carried out using the SPSS software package. Results. Connections between LIC and ferritin (r = 0.867; p 0.001), MIC and ferritin (r = 0.759; p = 0.004) and LIC and MIC (r = 0.737; p = 0.006) were found in patients with primary hemochromatosis, while in patients with secondary hemochromatosis significant correlations were found only between LIC and MIC (r = 0.503; p 0.001), while the relationship was average. Links between LIC and ferritin were found in patients with AA (r = 0.656; p = 0.040), an average relationship, in patients with TL (r = 0.714; p = 0.020), an average relationship. The relationship between MIC and ferritin was revealed in patients with AA (r = 0.703; p = 0.050), an average relationship, in patients with TL (r = 0.757; p = 0.018), an average relationship. At the same time, in patients with MDS and PMF in this study, there was no association between ferritin and LIC, ferritin and MIC. Conclusions. In patients with hereditary hemochromatosis, LIC and MIC are associated with ferritin, and MIC is also associated with LIC (medium bond). In patients with iron overload due to thalassemia, an average correlation between LIC and ferritin, MIC and ferritin was revealed. In patients with iron overload due to aplastic anemia, an average correlation between LIC and ferritin, MIC and ferritin was revealed.