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No evidence of increased cerebrovascular involvement in adult neurologically‐asymptomatic β‐Thalassaemia. A multicentre multimodal magnetic resonance study
Author(s) -
Tartaglione Immacolata,
Russo Camilla,
Elefante Andrea,
Caiazza Martina,
Casale Maddalena,
Di Concilio Rosanna,
Ciancio Angela,
De Michele Elisa,
Amendola Giovanni,
Gritti Paolo,
Carafa Pasquale A.,
Ferrantino Teresa,
Centanni Antonella,
Ippolito Noemi,
Caserta Violetta,
Oliveto Tiziana,
Granato Ilaria,
Femina Gianluca,
Esposito Fabrizio,
Ponticorvo Sara,
Russo Andrea G.,
Canna Antonietta,
Ermani Mario,
Cirillo Mario,
Perrotta Silverio,
Manara Renzo
Publication year - 2019
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.15834
Subject(s) - medicine , asymptomatic , magnetic resonance imaging , magnetic resonance angiography , radiology , white matter , thrombosis , hyperintensity , venography , cardiology
Summary Multi‐factorial causes jeopardize brain integrity in β‐thalassaemia. Intracranial parenchymal and vascular changes have been reported among young β‐thalassaemia patients but conventional magnetic resonance imaging ( MRI ) findings are contradictory making early MRI and magnetic resonance angiography ( MRA )/venography monitoring a matter of debate. This study prospectively investigated 75 neurologically asymptomatic β‐thalassaemia patients (mean‐age 35·2 ± 10·7 years; 52/75 transfusion‐dependent; 41/75 splenectomised) using a 3T magnetic resonance scanner; clinical, laboratory and treatment data were also collected. White matter ischaemic‐like abnormalities, intracranial artery stenoses, aneurysms and sinus venous thrombosis were compared between patients and 56 healthy controls (mean‐age 33·9 ± 10·8 years). No patient or control showed silent territorial or lacunar strokes, intracranial artery stenoses or signs of sinus thrombosis. White matter lesions were found both in patients (35/75, 46·7%) and controls (28/56, 50·0%), without differences in terms of number (4·0 ± 10·6 vs. 4·6 ± 9·1, P = 0·63), size and Fazekas’ Score. Intracranial aneurysms did not differ between patients and controls for incidence rate (7/75, 9·3% vs. 5/56, 8·9%), size and site. Vascular and parenchymal abnormality rate did not differ according to treatments or clinical phenotype. According to this study, asymptomatic β‐thalassaemia patients treated according to current guidelines do not seem to carry an increased risk of brain and intracranial vascular changes, thus weakening recommendations for regular brain MRI monitoring.