The Splenic Iron Deposition Correlation with the Hepatic and Myocardial Iron Concentration in the Patients with Beta-Thalassemia

Decreasing signal intensity of the spleen assessed by T2* MRI is a frequent finding in patients with beta-thalassemia due to iron deposition within the reticuloendothelial cells in this organ. This parameter can also be applied to determine the candidates for blood cell transfusion. However, the association between splenic siderosis and iron overload in other vital organs such as heart and liver remains unclear. The present study aimed to assess the correlation between iron deposition in splenic, hepatic and myocardial tissues by T2* relaxometry technique.

This cross-sectional study included 39 consecutive patients with a definitive diagnosis of beta-thalassemia major who underwent spleen, liver and heart MRI examinations for iron deposition and cardiac function.

No significant correlation was found between the heart and splenic T2* relaxation time (R=0.206, P=0.357). We revealed a strong correlation between the splenic T2* relaxation time and hepatic calculated T2*s (R=0.515, P=0.014). The liver T2* values can be predicted from the splenic T2*s by a new linear equation. According to the ROC curve analysis, the splenic T2* could significantly, but moderately predict moderate to severe from mild liver iron excess (AUC=0.667).

Our study demonstrated a significant linear correlation between the splenic and hepatic T2* relaxation time, probably indicative of the same iron deposition mechanism, and made us available to write a linear model that would predict the deposited iron density in the spleen with  the use of the magnetic resonance T2* values.