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Hepatic iron overload: diagnosis and quantification by noninvasive imaging
J L Chezmar1, R C Nelson, J A Malko
1Department of Radiology, Emory University School of Medicine, Atlanta, Georgia.
Gastrointestinal Radiology
|January 1, 1990
Summary
Magnetic resonance (MR) and computed tomography (CT) effectively detect severe hepatic iron overload. MR imaging, specifically liver to paraspinous muscle signal intensity ratios, offers greater specificity than CT for quantifying liver iron.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Hepatic iron overload necessitates accurate noninvasive diagnostic methods.
- Magnetic resonance (MR) and computed tomography (CT) are potential imaging modalities for assessing liver iron levels.
Purpose of the Study:
- To evaluate the diagnostic efficacy of MR and CT in detecting and quantifying hepatic iron in patients with suspected iron overload.
Main Methods:
- Thirty patients underwent MR imaging (SE 30,60/1000 or SE 30,60/2000) at 0.5 Tesla, calculating T2 and liver-to-paraspinous muscle (L/M) signal intensity ratios.
- Twenty-nine patients had noncontrast CT scans for hepatic attenuation measurement.
- Imaging results were correlated with quantitative liver biopsy iron determination.
Main Results:
- The L/M ratio on MR (SE 60/1000) was the best predictor of liver iron.
- Both MR (L/M < 0.6) and CT (> 70 HU) detected severe hepatic iron overload (biopsy > 600 µg/100 mg dry weight) with 100% sensitivity.
- MR demonstrated higher specificity (100%) than CT (50%) and better correlation with biopsy iron.
- T2 measurements showed poor correlation with hepatic iron.
- Neither method was sensitive for mild or moderate iron overload.
Conclusions:
- MR and CT are sensitive noninvasive techniques for detecting severe hepatic iron overload.
- MR imaging, particularly using L/M ratios, provides greater specificity than CT for hepatic iron quantification.