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Liver fat: effect of hepatic iron deposition on evaluation with opposed-phase MR imaging

Antonio C A Westphalen1, Aliya Qayyum, Benjamin M Yeh

  • 1Department of Radiology, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA 94143-0628, USA.

Radiology
|January 27, 2007
PubMed
Abstract

Insights

Liver iron deposition can interfere with magnetic resonance (MR) imaging assessments of liver fat. This study found that iron in the liver falsely lowers signal intensity, hindering accurate fat quantification using opposed-phase MR imaging.

Area of Science:

  • Radiology
  • Hepatology
  • Medical Imaging

Background:

  • Accurate assessment of liver fat is crucial for diagnosing and managing chronic liver disease.
  • Magnetic resonance (MR) imaging, particularly opposed-phase imaging, is a non-invasive method for quantifying liver fat.
  • Liver iron deposition is a common comorbidity in patients with chronic liver disease and may affect MR imaging findings.

Purpose of the Study:

  • To investigate the impact of liver iron deposition on the accuracy of liver fat quantification using opposed-phase MR imaging.
  • To determine if iron overload influences the correlation between MR signal intensity loss and histopathologically determined liver fat percentage.

Main Methods:

  • Retrospective analysis of 38 patients with cirrhosis who underwent abdominal MR imaging and liver biopsy.
  • Quantification of liver fat by two radiologists using signal intensity loss on opposed-phase and in-phase T1-weighted gradient-echo images.
  • Correlation analysis between MR-derived fat quantification and pathologist-determined liver fat percentage, stratified by the presence or absence of liver iron deposition.

Main Results:

  • Liver iron deposition was present in 25 out of 38 patients.
  • A significant correlation between MR signal intensity loss and liver fat percentage was observed in patients without iron deposition (r=0.7 and r=0.6).
  • This correlation was absent in patients with liver iron deposition (r=0.1 and r=-0.31), indicating that iron interferes with fat assessment.

Conclusions:

  • Signal intensity loss on in-phase MR images due to liver iron deposition is a significant confounding factor.
  • Opposed-phase MR imaging may overestimate or underestimate liver fat in the presence of iron overload.
  • Clinical interpretation of liver fat quantification by MR imaging in patients with chronic liver disease should consider potential iron interference.

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