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Iron overload related diseases and methods of liver iron quantification
Affiliations- Zakład Radiologii Ogólnej i Pediatrycznej Katedry Radiologii, Uniwersytet Medyczny we Wrocławiu, Polska
- Klinika Transplantacji Szpiku, Onkologii i Hematologii Dziecięcej, Uniwersytet Medyczny we Wrocławiu, Polska
open access
Abstract
Iron overload refers to the excessive accumulation of iron in different organs. It occurs in the course of increased intestinal absorption in hereditary hemochromatosis, repeated blood transfusions, or liver diseases. Excess of iron exerts toxic effect on internal organs leading to liver damage resulting in liver cirrhosis, liver failure, or hepatocellular carcinoma among others. Assessment of liver iron content is essential for diagnosing diseases caused by iron overload and monitoring of iron-reducing therapy. A biopsy is a gold standard of assessment of liver iron concentration; however, new techniques based on the use of magnetic resonance imaging (MRI) gain in importance, as they are non-invasive, reliable, and enable to evaluate iron content in areas inaccessible by biopsy such as brain. This article reviews the currently used methods for assessment of liver iron overload, especially using MRI, in terms of their clinical usefulness and accuracy in different diseases. The authors conclude that assessment of iron overload is difficult, especially in patients with very high or very low level of iron and should be conducted taking into account the patient's clinical condition and the course of primary disease. Increase in the popularity of magnetic resonance signal intensity ratio (SIR) results from its safety, relatively low costs, availability, and possibility to obtain reliable results.
Abstract
Iron overload refers to the excessive accumulation of iron in different organs. It occurs in the course of increased intestinal absorption in hereditary hemochromatosis, repeated blood transfusions, or liver diseases. Excess of iron exerts toxic effect on internal organs leading to liver damage resulting in liver cirrhosis, liver failure, or hepatocellular carcinoma among others. Assessment of liver iron content is essential for diagnosing diseases caused by iron overload and monitoring of iron-reducing therapy. A biopsy is a gold standard of assessment of liver iron concentration; however, new techniques based on the use of magnetic resonance imaging (MRI) gain in importance, as they are non-invasive, reliable, and enable to evaluate iron content in areas inaccessible by biopsy such as brain. This article reviews the currently used methods for assessment of liver iron overload, especially using MRI, in terms of their clinical usefulness and accuracy in different diseases. The authors conclude that assessment of iron overload is difficult, especially in patients with very high or very low level of iron and should be conducted taking into account the patient's clinical condition and the course of primary disease. Increase in the popularity of magnetic resonance signal intensity ratio (SIR) results from its safety, relatively low costs, availability, and possibility to obtain reliable results.
Keywords
Liver iron quantification; Magnetic resonance imaging; Relaxometry; Signal intensity ratio; Haemochromatosis; Iron overload
About this articleTitle
Iron overload related diseases and methods of liver iron quantification
Journal
Issue
Pages
308-315
Published online
2017-10-01
DOI
10.1016/j.achaem.2017.08.004
Bibliographic record
Acta Haematol Pol 2017;48(4):308-315.
Keywords
Liver iron quantification
Magnetic resonance imaging
Relaxometry
Signal intensity ratio
Haemochromatosis
Iron overload
Authors
Cyprian Olchowy
Jowita Frączkiewicz
Marcin Pawłowski
Daria Smoląg
Anna Olchowy
Adam Maślak
Urszula Zaleska-Dorobisz
Krzysztof Kałwak