Pituitary Volume and Iron Overload Evaluation by 3T MRI in Thalassemia.

Autor: Nayak AM; Department of Pediatrics, Nanavati Super Speciality Hospital, Mumbai, Maharashtra, India. dr.anujanayak@gmail.com., Choudhari A; Department of Radiology, Nanavati Super Speciality Hospital, Mumbai, Maharashtra, India., Patkar DP; Department of Radiology, Nanavati Super Speciality Hospital, Mumbai, Maharashtra, India., Merchant RH; Department of Pediatrics, Nanavati Super Speciality Hospital, Mumbai, Maharashtra, India.
Jazyk: angličtina
Zdroj: Indian journal of pediatrics [Indian J Pediatr] 2021 Jul; Vol. 88 (7), pp. 656-662. Date of Electronic Publication: 2021 Mar 06.
DOI: 10.1007/s12098-020-03629-w
Abstrakt: Objective: To evaluate pituitary volume and iron overload in beta thalassemia major, with the objective of assessing the reliability of this method in predicting hypogonadism.
Methods: 3T MRI was used to measure pituitary R2 and T2* in 57 beta thalassemia major patients and 30 controls. Anterior pituitary volume was evaluated by MRI planimetry. Cardiac, hepatic, and pancreatic iron overload were also assessed using MRI T2*. Mean serum ferritin was estimated by sandwich immuno-assay. Short stature was defined as height < 3 rd percentile for age, and clinical hypogonadism defined as absence of secondary sexual characteristics at ages ≥ 13 y for females and ≥ 14 y for males.
Results: Short stature was present in 32 patients (56.1%). Of the 47 patients in the pubertal age group, 11(23.4%) had hypogonadism. Serum ferritin correlated positively with pituitary R2 (p = 0.004) and negatively with anterior pituitary volume (p = 0.006), whereas pituitary R2 correlated negatively with cardiac T2* (p = 0.001). Patients with hypogonadism had lower pituitary R2 (p = 0.186), T2* (p = 0.048), and anterior pituitary volumes (p = 0.012) compared to those with normal sexual maturity. Regardless of stature, no significant difference was observed between pituitary R2 (p = 0.267) and T2* (p = 0.451). Mean pituitary R2 in patients (78.99 Hz) was higher than in controls (20.8 Hz) (p = 0.0001). Anterior pituitary volume was lower in patients (264.83 mm 3 ) than in controls (380.87 mm 3 ) (p = 0.0001). A threshold value of 22.85 Hz for pituitary R2 gave a sensitivity of 84.2% and a specificity of 73.3% in distinguishing pituitary iron content of patients from controls, with an area of 0.864 under the ROC curve.
Conclusions: 3T MRI is a reliable method to detect pituitary iron overload and predict risk of hypogonadism in beta Thalassemia.
Databáze: MEDLINE
Externí odkaz: