MR MARROW SIGNS OF IRON OVERLOAD IN TRANSFUSION-DEPENDENT PATIENTS WITH SICKLE-CELL DISEASE

Magnetic resonance (MR) marrow signal in the axial and appendicular sk eleton of 13 transfusion-dependent and chelated pediatric patients wit h sickle cell anemia (SSD) was compared with marrow signal in six non- transfusion-dependent patients with SSD. Hepatic, pancreatic, and rena l MR signal were also evaluated, Indication for hypertransfusion thera py was primarily prior history of stroke. Transfusion-dependent patien ts had evidence of iron deposition throughout the imaged marrow and th e liver, despite deferoxamine chelation therapy. Non-transfusion-depen dent patients did not demonstrate grossly apparent signs of iron overl oad. Red marrow restoration was present in the spine, pelvis, and long bones and, in some patients, within the epiphyses. Marrow edema secon dary to vaso-occlusive crises was evident in the metaphyses and diaphy ses of long bones in areas of both red and fatty marrow and was best s een using fat-saturated T2-weighted imaging techniques.