Figure 5.
Magnetic resonance scans in patients with thalassemia major.Left scans are horizontal long axis, the right ones mid-short axis. (A) Low myocardial iron deposition. The left ventricular volumes are normal, and myocardial signal intensity (long arrow) is similar to that arising from skeletal muscle (short arrow). Left ventricular ejection fraction was 70%. In this case, the liver is very dark (dotted arrow), indicating heavy hepatic iron deposition despite the normal myocardial appearances. (B) Severe myocardial iron overload. The myocardial signal intensity is dark (long arrow) compared with skeletal muscle (short arrow). The ventricle is dilated and thickened. Cine imaging showed greatly reduced systolic function (left ventricular ejection fraction 39%) with a restrictive filling pattern. Liver signal in this case is well preserved (dotted arrow).
Reproduced with permission from
Anderson LJ, Wonke N, Prescott E, et al. Improved myocardial iron levels and ventricular function with oral deferiprone compared with subcutaneous desferrioxamine in thalassaemia. Lancet. 2002;360:516–520..