MR imaging of pancreatic changes in patients with transfusion dependent beta-thalassemia major

OBJECTIVE, The aim of this study was to evaluate MR imaging changes of the pancreas in patients with transfusion-dependent beta-thalassemia major SUBJECTS AND METHODS. Twenty patients with transfusion-dependent P-thalasse mia major were examined using MR imaging at 0.5 T, with spin-echo T1-weight ed, fast spin-echo T2-weighted, and gradient-echo T2*-weighted sequences. I mage analysis was performed to assess pancreas-to-fat signal intensity rati os for all pulse sequences. Pancreatic exocrine and endocrine function and serum ferritin levels were assessed, Twenty healthy volunteers underwent MR imaging with the same three sequences and served as a control group. RESULTS, The pancreas-to-fat signal intensity ratio was significantly decre ased in 17 (85%) of the 20 patients on spin-echo T1-weighted images (p <.05 ), fast spin-echo T2-weighted images (p <.01), and gradient-echo T2*-weight ed images (p <.01) when compared with the 20 volunteers in the control grou p. The pancreas-to-fat signal intensity ratio was significantly increased i n three (15%) of the 20 patients on spin-echo T1-weighted images (p <.01) a nd fast spin-echo T2-weighted images (p < .05). In addition, in the 20 patients, we found a significant correlation between increased pancreas-to-fat signal intensity ratios and decreased serum tryp sin levels (r = -.77, p < .01 for spin-echo T1-weighted sequences; r = -.75 , p < .05 for fast spin-echo T2-weighted sequences; and r = -.74, p < .05 f or gradient-echo T2*-weighted sequences). Likewise, for the 20 patients, we found a significant correlation between decreased pancreas-to-fat signal i ntensity ratios and increased serum ferritin levels for gradient-echo T2*-w eighted images (r = .65,p <.01). No correlation was found for the other cli nical parameters evaluated. CONCLUSION. MR imaging revealed signal intensity changes in the pancreas of patients with transfusion-dependent beta-thalassemia major. Patients with a major impairment of the exocrine pancreatic function had higher signal in tensity of the pancreas because of fatty replacement of the parenchyma.