Highlights
- •Liver T2 and T2* have excellent agreement and consistency.
- •Bright- and dark-blood T2* sequences yield similar values. The later improves visualization of the myocardium and analysis.
- •Liver T2* estimation using the liver parenchyma available in the cardiac acquisition is feasible and accurate
- •The decision to use a single sequence for cardiac and liver T2* estimation should be taken according to each patient
- •A single breath hold GRE sequence for liver and cardiac T2* requires optimization for patients with severe iron overload
Abstract
Objective
To determine the optimal MRI protocol and sequences for liver and cardiac iron estimation
in children.
Methods
We evaluated patients ≤18 years with cardiac and liver MRIs for iron content estimation.
Liver T2 was determined by a third-party company. Cardiac and Liver T2* values were
measured by an observer. Liver T2* values were calculated using the available liver
parenchyma in the cardiac MRI. Linear correlations and Bland-Altman plots were run
between liver T2 and T2*, cardiac T2* values; and liver T2* on dedicated cardiac and
liver MRIs.
Results
139 patients were included. Mean liver T2 and T2* values were 8.6 ± 5.4 ms and 4.5 ± 4.1 ms,
respectively. A strong correlation between liver T2 and T2* values was observed (r = 0.96,
p < 0.001) with a bias (+4.1 ms). Mean cardiac bright- and dark-blood T2* values were
26.5 ± 12.9 ms and 27.2 ± 11.9 ms, respectively. Cardiac T2* values showed a strong
correlation (r = 0.81, p < 0.001) with a low bias (−1.0 ms). The mean liver T2* on liver and cardiac MRIs
were 4.9 ± 4.7 ms and 4.6 ± 3.9 ms, respectively. A strong correlation between T2*
values was observed (r = 0.96, p < 0.001) with a small bias (−0.2 ms).
Conclusion
MRI protocols for iron concentration in the liver and the heart can be simplified
to avoid redundant information and reduce scan time. In most patients, a single breath-hold
GRE sequence can be used to evaluate the iron concentration in both the liver and
heart.
Keywords
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Article info
Publication history
Published online: February 20, 2019
Accepted:
February 19,
2019
Received in revised form:
January 31,
2019
Received:
December 17,
2018
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
