Abstract
Magnetic resonance (MR) marrow signal in the axial and appendicular skeleton of 13 transfusiondependent and chelated pediatric patients with sickle cell anemia (SSD) was compared with marrow signal in six non-transfusion-dependent patients with SSD. Hepatic, pancreatic, and renal MR signal were also evaluated. Indication for hypertransfusion therapy was primarily prior history of stroke. Transfusion-dependent patients had evidence of iron deposition throughout the imaged marrow and the liver, despite deferoxamine chelation therapy. Non-transfusion-dependent patients did not demonstrate grossly apparent signs of iron overload. Red marrow restoration was present in the spine, pelvis and long bones and, in some patients, within the epiphyses. Marrow edema secondary to vaso-occlusive crises was evident in the metaphyses and diaphyses of long bones in areas of both red and fatty marrow and was best seen using fat-saturated T2-weighted imaging techniques.
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Mankad VN, Williams JP, Harpen MD et al (1990) Magnetic resonance imaging of bone marrow in sickle cell disease: clinical, hematologic and pathologic correlations. Blood 75: 274–283
Rao VM, Mitchell DG, Rifkin MD et al (1989) Marrow infarction in sickle cell anemia: correlation with marrow type and distribution by MRI. Magn Reson Iamging 7: 39–44
Siegelman ES, Outwater E, Hanau CA et al (1994) Abdominal iron distribution in sickle cell disease: MR findings in transfusion and nontransfusion dependent patients. J Comput Assist Tomogr 18: 63–67
Kaneko K, Humbert JH, Kogutt MS et al (1993) Iron deposition in cranial bone marrow with sickle cell disease: MR assessment using a fat suppression technique. Pediatr Radiol 23: 435–438
Moore SG, Dawson KL (1990) Red and yellow marrow in the femur: age-related changes in appearance at MR imaging. Radiology 175: 219–223
Magid D, Fishman EK, Siegelman SS (1984) Computed tomography of the spleen and liver in sickle cell disease. AJR 143: 245–249
Flyer MA, Haller JO, Sundaram R (1993) Transfusional hemosiderosis in sickle cell anemia: another cause of an echogenic pancreas. Pediatr Radiol 23: 140–142
Nathan DA, Osler FA (1993) Hematology of infancy and childhood, 4th edn. Saunders, Philadelphia, pp. 732–782
Jaramillo D, Laor, T, Hoffer FA, et al (1991) Epiphyseal marrow in infancy: MR imaging. Radiology 180: 809–812
Richardson ML, Patten RM (1994) Age-related changes in marrow distribution in the shoulder: MR imaging findings. Radiology 192: 209–215
Glaser AM, Chen DCP, Siegel ME et al (1989) An unusual scintigraphic pattern in sickle cell patients. Eur J Nucl Med 15: 357–360
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Levin, T.L., Sheth, S.S., Hurlet, A. et al. MR marrow signs of iron overload in transfusion-dependent patients with sickle cell disease. Pediatr Radiol 25, 614–618 (1995). https://doi.org/10.1007/BF02011829
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DOI: https://doi.org/10.1007/BF02011829