A T2* magnetic resonance imaging study of pancreatic iron overload in thalassemia major.

We studied the utility of pancreatic magnetic resonance imaging (MRI) in 72 thalassemia major patients (21 diabetic, 51 normoglycemic). Diabetic patients were significantly older (p<0.0001) and had smaller pancreas volume (p<0.0001). The two groups were comparable for ferritin and MRI-T2* heart, liver and pancreas. Pancreatic T2* signals were abnormal in 80% of both groups, and correlated with heart T2*. In normoglycemic patients, cardiac T2* and log-pancreatic T2* values correlated with homeostatic model assessments HOMA-B (beta cell reserve), HOMA-IR (insulin resistance) and fasting insulin/C-peptide levels. This suggested that improved chelation may improve beta cell reserve and prevent pancreatic atrophy.