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Hepatic iron concentration: noninvasive estimation by means of MR imaging techniques

H L Bonkovsky1, R B Rubin, E E Cable

  • 1Dept of Medicine, University of Massachusetts Medical School, Worcester, USA. Herbert.Bonkovsky@ummhc.org

Radiology
|July 16, 1999
PubMed
Abstract

Insights

Magnetic resonance (MR) imaging can accurately estimate hepatic iron concentration, offering a noninvasive alternative to liver biopsy. Specific gradient-recalled-echo (GRE) sequences provide precise measurements, potentially replacing invasive procedures.

Area of Science:

  • Radiology
  • Medical Imaging
  • Hepatology

Background:

  • Hepatic iron overload requires accurate quantification.
  • Liver biopsy is the traditional method for measuring hepatic iron concentration but is invasive.
  • Noninvasive methods for assessing iron levels are needed.

Purpose of the Study:

  • To identify a magnetic resonance (MR) imaging technique for sensitive and specific estimation of hepatic iron content.
  • To determine if MR imaging can replace liver biopsy for hepatic iron concentration measurement.

Main Methods:

  • Thirty-eight patients underwent liver biopsy and hepatic MR imaging.
  • Various spin-echo and gradient-recalled-echo (GRE) MR techniques were employed.
  • Correlations between MR imaging parameters and chemically measured hepatic iron concentration were analyzed.

Main Results:

  • Inverse curvilinear relationships were observed between MR parameters and hepatic iron concentration.
  • GRE sequences with short repetition and echo times demonstrated superior accuracy and precision over spin-echo sequences.
  • A specific GRE sequence (TR 18 msec, TE 5 msec, flip angle 10 degrees) showed a strong correlation (r = -0.94) with hepatic iron concentration and low variability (12% coefficient of variation).

Conclusions:

  • MR imaging, particularly with optimized GRE parameters, is a rapid, noninvasive, and accurate method for estimating hepatic iron concentration.
  • This MR imaging approach is sufficiently accurate and precise to obviate the need for liver biopsy in measuring hepatic iron concentration.

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