Increased iron deposition of deep cerebral gray matter structures in hemodialysis patients: A longitudinal study using quantitative susceptibility mapping

Background The cerebral iron overload in hemodialysis patients has been reported in a previous study, in which the evaluation of the changes in iron content could be affected by the cross‐sectional analysis. Purpose To investigate the longitudinal changes of iron deposition in hemodialysis patients using quantitative susceptibility mapping (QSM) and correlate these findings with the longitudinal changes of neurocognitive function and clinical factors. Study Type Prospective; longitudinal. Population In all, 34 patients and 30 healthy controls (HCs); the mean follow‐up interval was 22 ± 7 months. Field Strength/Sequence 3.0T, susceptibility‐weighted imaging (SWI). Assessment QSM reconstructed from original phase data of SWI was used to measure the susceptibility of gray matter structures including bilateral caudate nucleus (CN), globus pallidus (GP), putmen (PUT), red nucleus (RN), substantia nigra (SN), dentate nucleus (DN), thalamus (THA), pulvinar of thalamus (PT). The Mini‐Mental State Examination (MMSE) test and clinical factors were recorded. Statistical Testing Analysis of covariance adjusting for age and gender as covariates or a paired t‐test for the differences in susceptibility, MMSE scores, and clinical factors among baseline, follow‐up patients, and HCs. Correlation and stepwise regression analysis for the relationship between susceptibility, MMSE scores, and clinical factors. Results The susceptibility of bilateral CN, GP, PUT, RN, SN, DN, THA, PT in follow‐up patients was significantly higher than that in baseline between patients and HCs except for left THA (all P