The pancreas in beta-thalassemia major: MR imaging features and correlation with iron stores and glucose disturbances

Eur Radiol. 2007 Jun;17(6):1535-43. doi: 10.1007/s00330-006-0507-8. Epub 2006 Dec 6.

Abstract

The study aims at describing the MR features of pancreas in beta-thalassemia major, investigating the relations between MR findings and glucose disturbances and between hepatic and pancreatic siderosis. Signal intensity ratios of the pancreas and liver to right paraspinous muscle (P/M, L/M) were retrospectively assessed on abdominal MR imaging studies of 31 transfusion-dependent patients with beta-thalassemia major undergoing quantification of hepatic siderosis and 10 healthy controls, using T1- (120/4/90), intermediate in and out of phase - (120/2.7, 4/20), and T2*-(120/15/20) weighted GRE sequences. Using the signal drop of the liver and pancreas on opposed phase images, we recorded serum ferritin and results of oral glucose tolerance test (OGTT). Decreased L/M and P/M on at least the T2* sequence were noticed in 31/31 and 30/31 patients, respectively, but no correlation between P/M and L/M was found. Patients with pathologic OGTT displayed a higher degree of hepatic siderosis (p < 0.04) and signal drop of pancreas on opposed phase imaging (p < 0.025), implying fatty replacement of pancreas. P/M was neither correlated with glucose disturbances nor serum ferritin. Iron deposition in the pancreas cannot be predicted by the degree of hepatic siderosis in beta-thalassemia major. Fatty replacement of the pancreas is common and may be associated with glucose disturbances.

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Blood Glucose / analysis
  • Blood Transfusion
  • Case-Control Studies
  • Female
  • Ferritins / blood
  • Glucose Tolerance Test
  • Humans
  • Iron Overload / pathology*
  • Linear Models
  • Magnetic Resonance Imaging / methods*
  • Male
  • Pancreas / pathology*
  • Pancreatic Function Tests
  • Retrospective Studies
  • beta-Thalassemia / pathology*

Substances

  • Blood Glucose
  • Ferritins