Association of iron overload based quantitative T2* MRI technique and carotid intima-media thickness in patients with beta-thalassemia: a cross-sectional study.

BACKGROUND: Body iron status has been implicated in atherosclerotic cardiovascular disease. The main hypothesis is that high iron status is associated with increased risk of atherosclerosis. We investigated the potential role of iron as an additional risk factor promoting atherosclerosis among beta-thalassemic patients. METHODS: In this cross-sectional study, the liver iron load was assessed by quantitative T2* MRI technique and intima-media thickness (IMT) of the common carotid artery by high-resolution ultrasound among 119 patients (62 male, 57 female) with beta-thalassemia (major and intermediate) whose age ranged from 10 to 50 years with a mean of 25.6 years. The patients were divided into three groups according to the severity of iron loading, obtained by T2*MRI technique: group I (normal), group II (mild) and group III (moderate and severe) iron load.For elimination of the effect of age on carotid IMT values, the patients also were divided into four age groups (10-19 y, 20-29 y, 30-39 y and 40-50 y). Mean carotid IMT based on the severity of iron loading were compared at different age groups, using one way ANOVA analysis for assessing the effect of iron loading on carotid IMT. Pearson's coefficient of correlation were used to assess the degree of correlation between studied variables (liver T2*, IMT, age). RESULTS: There were significant differences in mean carotid IMT based on the severity of iron loading at different age groups, with P = 0.003 at 20-29 y, P = 0.006 at 30-39 y and p = 0.037 at 40-50 y. Age (p = 0.001) and liver T2*(p = 0.003) had significant correlation with mean carotid IMT independently.At the age group of 10-19 years, there were not significant differences in mean carotid IMT based on the liver iron loading (p = 0.661).No significant differences also are seen in mean carotid IMT between male and female (p = 0.41). CONCLUSIONS: This study identified a relationship between body iron status and carotid IMT. This relationship support to the hypothesis of a link between body iron load and atherosclerosis.

Evaluation of Respiratory Triggered Diffusion-Weighted MRI with Three b-Values Compared to ADC Map and Fast Spin Echo Heavily T2W in Differential Diagnosis of Hemangioma from Malignant Liver Lesions.

PURPOSE: The goal of this study was to evaluate the ability of diffusion-weighted imaging (DWI) with three different b-values compared to apparent diffusion coefficient (ADC) map and fast spin echo heavily T2 weighted (FSE-HT2W) in differential diagnosis of hemangioma from malignant liver lesions. METHODS: Fifty-four liver lesions in 20 patients (12 females and eight males: mean age of 52 ± 12.3 years) were examined in this study. FSE-HT2W with breath-hold technique and DWI using respiratory triggered with three different b-values (50,400 and 800 s/mm2) were performed on all patients. Mean ADC values were calculated from each lesion. Agreement levels of each sequence with standard of reference were compared by constructing the receiver operating characteristics (ROC) curve and calculation of the area under the ROC curve. RESULTS: ADC maps had the largest area under the ROC curve and also the most agreement with the standard of reference. DWI obtained with high b-value (b-800 s/mm2) and FSE-HT2W technique were ranked next, respectively. Hemangiomas had significantly higher ADC values than malignant liver lesions (P = .001). No significant differences were seen in gender, age, and lesion size between two lesion groups. CONCLUSIONS: ADC maps and DWI in high b-values are more successful than FSE-HT2W technique in differential diagnosis of hemangioma from malignant liver lesions.