A 34-year-old man with bronzed skin, diabetes mellitus, and a newly diagnosed dilated cardiomyopathy is suspected to have hereditary hemochromatosis. Which non-invasive investigation best quantifies myocardial iron deposition?
- A Serum ferritin level
- B Transthoracic echocardiography with strain imaging
- C Cardiac MRI T2-star measurement ✓
- D Thallium perfusion scan
Correct answer: C. Cardiac MRI T2-star measurement
Explanation
Cardiac MRI T2-star quantifies myocardial iron directly, since deposited iron shortens T2-star relaxation time; values below 20 ms indicate cardiac iron overload and guide chelation. Serum ferritin reflects total body iron stores and correlates poorly with myocardial iron, which is why it is the key distractor. Endomyocardial biopsy with Prussian blue stain is diagnostic but invasive and sampling-error prone, and it does not fit the non-invasive requirement of the stem.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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