Marrow Fat Content and Composition in β-Thalassemia: A Study using 1 H-MRS

Ismail UN 1 , Azlan CA 1 , Khairullah S 2 , Azman RR 1 , Omar NF 3 , Md Shah MN 1 Show all authors , Yeong CH 4 , Jackson N 5 , Ng KH 1

Affiliations 

  • 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 2 Haematology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 3 Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
  • 4 School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
  • 5 Red Cell Unit, Department of Haematology, University College Hospital, London, UK
J Magn Reson Imaging, 2021 01;53(1):190-198.
PMID: 33237616 DOI: 10.1002/jmri.27294

Abstract

BACKGROUND: β-thalassemia is a genetic disease that causes abnormal production of red blood cells (ineffective erythropoiesis, IE). IE is a condition known to change bone marrow composition.

PURPOSE: To evaluate the effect of IE on the marrow fat content and fat unsaturation levels in the proximal femur using 1 H-MRS.

STUDY TYPE: Prospective.

SUBJECTS: Twenty-three subjects were included in this study, seven control and 16 β-thalassemia subjects.

FIELD STRENGTH/SEQUENCE: 3.0T; stimulated echo acquisition Mode (STEAM); magnetic resonance spectroscopy (MRS) sequence.

ASSESSMENT: Multiecho MRS scans were performed in four regions of the proximal left femur of each subject, that is, diaphysis, femoral neck, femoral head, and greater trochanter. The examined regions were grouped into red (diaphysis and femoral neck) and yellow marrow regions (femoral head and greater trochanter).

STATISTICAL TESTS: The Jonckheere-Terpstra test was used to evaluate the impact of increasing disease severity on bone marrow fat fraction (BMFF), marrow conversion index, and fat unsaturation index (UI). Pairwise comparison analysis was performed when a significant trend (P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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