Cardiac MRI for Iron Overload in pediatric thalassemia patients- Right Age to Start in a Resource Constrained Environment.

The aim of this article is to assess the prevalence and severity of myocardial iron overload in thalassemia patients who present for the first time for cardiac MRI and to define the right age to start screening, in a resource-constrained environment. All MRI scans done at our institute for myocardial iron overload assessment in thalassemia patients, between 2015 and 2018 were analysed. Patients up to the age of 30 years were included. There were a total of 600 patients, (Age group between 2 and 30 years). All these scans were retrospectively analysed and severity of myocardial iron overload was categorized as normal, mild, moderate and severe based on the bright blood T2* equivalent values at 1.5 T. Overall prevalence of myocardial iron overload was 32.3%, while the prevalence of myocardial iron overload in patients in the age group 0-10 was 10.2%.There were 40 patients in the age group 0-6 years, of whom, only 2 had myocardial iron overload. In patients less than or equal to 6 years of age, the number of patients with iron overload was very small and this may be used to decide the optimal age for scanning.