Abstract Background: Accurate myocardial iron quantification is essential for preventing iron overload cardiomyopathy, optimizing chelation therapy, and monitoring treatment response in patients with hemolytic anemias. While T2* is an established noninvasive technique for assessing cardiac iron overload (CIO), native T1 and T2 mapping are emerging parametric methods. The aim of this study was to evaluate native myocardial T1, T2, and T2* values in patients with hemolytic anemia. Materials and Methods: Forty consecutive patients with hemolytic anemia were evaluated using a 1.5 T magnetic resonance imaging scanner (Siemens Magnetom Avanto fit). Ventricular short-axis cine steady-state free precession images were acquired, along with single midventricular short-axis slices for T2*, T1, and T2 mapping. T1 and T2 measurements were obtained from automated parametric maps (Siemens MyoMaps) using manually drawn large midmyocardial regions of interest (>20 pixels). Siemens Syngo Workstation was used to calculate left ventricular function. Results: Cardiac T2* demonstrated a strong positive correlation with both native T1 ( r = 0.821) and T2 mapping ( r = 0.828). However, 30% of the study population had normal T2* values despite reduced T1 (<966 ms). Patient age, serum ferritin, and cardiac function exhibited only weak associations with cardiac T2*, T1, and T2 mapping values. Conclusion: Cardiac T1 and T2 mapping correlated strongly with cardiac T2*. The finding of a subset of patients with normal T2* values but low T1 values suggests that T1 mapping may have higher sensitivity for detecting patients with early/mild CIO, who may be missed by T2* evaluation alone.
Georgy et al. (Thu,) studied this question.