open access

Vol 48, No 4 (2017)
Prace poglądowe / Reviews
Published online: 2017-10-01
Submitted: 2017-05-22
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Iron overload related diseases and methods of liver iron quantification

Cyprian Olchowy1, Jowita Frączkiewicz2, Marcin Pawłowski1, Daria Smoląg1, Anna Olchowy1, Adam Maślak1, Urszula Zaleska-Dorobisz1, Krzysztof Kałwak2
DOI: 10.1016/j.achaem.2017.08.004
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Acta Haematol Pol 2017;48(4):308-315.
Affiliations
  1. Zakład Radiologii Ogólnej i Pediatrycznej Katedry Radiologii, Uniwersytet Medyczny we Wrocławiu, Polska
  2. Klinika Transplantacji Szpiku, Onkologii i Hematologii Dziecięcej, Uniwersytet Medyczny we Wrocławiu, Polska

open access

Vol 48, No 4 (2017)
Prace poglądowe / Reviews
Published online: 2017-10-01
Submitted: 2017-05-22

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.

Get Citation

Keywords

Liver iron quantification; Magnetic resonance imaging; Relaxometry; Signal intensity ratio; Haemochromatosis; Iron overload

About this article
Title

Iron overload related diseases and methods of liver iron quantification

Journal

Acta Haematologica Polonica

Issue

Vol 48, No 4 (2017)

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

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