Assessment of pituitary iron overload with t2 (star) in thalassemic patients and normal group

In beta thalassemia major (BTM) patients, toxic iron overload throughout the body and related pathologies occur secondary to recurrent blood transfusions. Iron overload in the tissues is measured most frequently by MRI today. In our study, it was aimed to investigate the factors affecting pituitary iron overload in patients with BTM. For this purpose, we examined the relation of pituitary T2 * value with heart-liver iron overload, serum ferritin (SF) levels, splenectomy and pituitary height. Our study was performed between April 2014 and February 2020, with a group of 144 patients diagnosed with BTM and 48-person control group. All shots were taken on the same 1.5 Tesla MR scanner and images were obtained with multiecho GRE sequence. In the control group pituitary imaging was performed and in the patient group pituitary, cardiac and liver imaging was performed. T2 * value was measured with computer program (CMR Tools) from GRE images. Pituitary heights were measured in both groups. SF level in the patient group and splenectomy, if performed, were recorded. In our study, a significant difference was found between the patient-control group in terms of pituitary T2 * values (p = 0.039). In the patient group, the pituitary T2 * value was correlated positively with the cardiac and liver T2 * values and negatively with the serum ferritin levels (p <0.001; p <0.001; p <0.001, respectively). The highest sensitivity and specificity values were determined as pathological threshold values for iron overload in the pituitary, when the cut-off point was accepted as 9.88 ms sensitivity was 83.3%, specificity was 93.8%; when the cut-off point was accepted as 11.9 ms, sensitivity was 91.7%, and specificity was 79.2%. In patients with splenectomy, iron overload in the pituitary and heart increased (p <0.05; p <0.001, respectively). There was no significant difference in SF levels and liver T2 * values (p> 0.05). Result: There was a significant difference between the patient and control groups in terms of pituitary T2 * value. It was determined that pituitary iron overload was associated with cardiac-liver T2 * values, SF levels and patient age; splenectomy caused an increase in iron overload in the pituitary.