Quantification of liver iron overload by T2 quantitative magnetic resonance imaging in thalassemia: Impact of chronic hepatitis C on measurements

Purpose: Measurement of liver T2 values seems to be an accurate and sensiti ve magnetic resonance imaging (MRI) method for the quantification of liver hemosiderosis in multiple transfused patients with thalassemia. Because man y of these patients have coexistent chronic hepatitis C virus (HCV) infecti on, the effect of inflammatory changes on liver T2 values was assessed. Materials and Methods: Liver MRI studies of 35 HCV+ and 17 HCV- patients wi th beta-thalassemia, 9 HCV+ patients without thalassemia, and 10 healthy co ntrols of the same age range (13 to 32 years) were reviewed. Iron status wa s assessed by serum ferritin in all patients, and determination of liver ir on concentration (LIC) was available in 16 HCV+ patients with thalassemia. Histologic activity index (HAI) and grades of siderosis were evaluated in a ll HCV+ patients with thalassemia. Results: Patients with thalassemia had significantly lower T2 values (P < 0 .0001) than subjects without thalassemia, whereas no difference existed bet ween HCV+ patients without thalassemia and healthy controls. In HCV+ patien ts, LIC correlated more nearly with T2 values (r = 0.93) than with serum fe rritin (r = 0.73). T2 values were not influenced by HAI score or fibrosis. Conclusion: Liver T2 values were found to be more accurate than serum ferri tin in predicting liver iron overload and were not influenced by the presen ce of chronic hepatitis C. Therefore, MRI could serve as a noninvasive alte rnative to liver biopsy for the quantification of hemosiderosis in HCV+ pat ients with thalassemia.