1. No evidence of increased cerebrovascular involvement in adult neurologically-asymptomatic β-Thalassaemia. A multicentre multimodal magnetic resonance study
- Author
-
Gianluca Femina, Antonietta Canna, Sara Ponticorvo, Renzo Manara, Violetta Caserta, Maddalena Casale, Paolo Gritti, Elisa De Michele, Silverio Perrotta, Andrea G. Russo, Teresa Ferrantino, Camilla Russo, Martina Caiazza, Mario Cirillo, Giovanni Amendola, Antonella Centanni, Noemi Ippolito, Fabrizio Esposito, Angela Ciancio, Rosanna Di Concilio, Andrea Elefante, Ilaria Granato, Mario Ermani, Tiziana Oliveto, Pasquale Alessandro Carafa, Immacolata Tartaglione, 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, Tartaglione, I., Russo, C., Elefante, A., Caiazza, M., Casale, M., Di Concilio, R., Ciancio, A., De Michele, E., Amendola, G., Gritti, P., Carafa, P. A., Ferrantino, T., Centanni, A., Ippolito, N., Caserta, V., Oliveto, T., Granato, I., Femina, G., Esposito, F., Ponticorvo, S., Russo, A. G., Canna, A., Ermani, M., Cirillo, M., Perrotta, S., and Manara, R. more...
- Subjects
Adult ,medicine.medical_specialty ,brain MRI ,Adolescent ,transfusion medicine ,Venography ,thalassaemia ,Asymptomatic ,Magnetic resonance angiography ,Brain Ischemia ,White matter ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Leukoencephalopathies ,medicine ,Humans ,thrombosi ,Prospective Studies ,vascular malformations ,thrombosis ,Aged ,medicine.diagnostic_test ,business.industry ,beta-Thalassemia ,Brain ,Intracranial Aneurysm ,Magnetic resonance imaging ,Intracranial Artery ,Hematology ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,White Matter ,Thrombosis ,Hyperintensity ,medicine.anatomical_structure ,Case-Control Studies ,030220 oncology & carcinogenesis ,Radiology ,Nervous System Diseases ,medicine.symptom ,business ,Magnetic Resonance Angiography ,030215 immunology - Abstract
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±10·7years; 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±10·8years). 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. more...
- Published
- 2019