ABDOMINAL IRON DISTRIBUTION IN SICKLE-CELL DISEASE - MR FINDINGS IN TRANSFUSION AND NONTRANSFUSION DEPENDENT PATIENTS

Objective: Our goal was to determine the difference in iron distributi on between transfusion dependent (TD) and nontransfusion dependent (NT ) patients with sickle cell disease (SCD). Materials and Methods: The T2-weighted and T2-weighted abdominal MR images in nine cases of homo zygous SCD were reviewed to determine the distribution of low signal f rom iron in five TD and four NT patients. Results: All eight patients with visualized spleens had decreased splenic signal intensity. One pa tient who had no history of splenectomy had no visualized splenic tiss ue. The majority of both groups had renal cortex of low signal intensi ty that was attributable to iron deposition from intravascular hemolys is and was not correlated with clinical renal abnormalities. None of t he NT group had liver or pancreas of low signal intensity, while all f ive TD patients had decreased liver signal intensity and three of five had decreased pancreatic signal intensity. Conclusion: Decreased panc reatic signal intensity can occur in TD patients, perhaps suggesting t otal body iron overload. Nontransfusion dependent sickle cell patients usually have normal hepatic signal intensity and do not have total bo dy iron overload, even in the presence of renal and splenic iron depos ition.