Editorials David

D. Stark,

MD

Hepatic

I

Iron

overload

RON

is common

pnisingly

difficult

Primary

affecting

one

northern

European

increased

intestinal

etary

iron

tosis

results

tration

(2). iron

dietary liver

overload The

has as

(ferric

no

iron

excess

iron,

tissue tients sis,

The

influences

which (5-7).

with

hereditary

example,

to

Experimental

iron

capacity

of

the

sites

mosidenin),

with

high fennitin

cess

low-molecular-weight

lieved

pool

(8).

lipid

the

cellular

cell

membrane

and

Transfusional

iron

to

er,

diseases,

761.594

er, MR studies, (MR),

contrast

Radiology

#{149} Liver,

761.1214

iron

content

#{149} Magnetic

a

iron

overload,

ship

of

Liv-

creatic

Liv-

late

vard

Medical

Schoo!

a! Hospital.

32

ceived

and

ported

by

no.

Fruit

accepted National

and St.

February

of

1991. Health

to

the author. RSNA,

1991

See also the articles by Siegelman 361-366) issue.

and

Gomori

et a! (pp

et a! (pp

367-369)

in this

from of

may

of

come-

demonstration

in

detecting

iron

in

patients

levels with

disease and the correlation pancreatic iron levels and

Early

to

diagnosis

therapy

criteria and

of hemo-

are notoriously

nonspecific

an

low

(3,4). Ele-

enhancement (Ti).

hancement

250

respon-

intensity,

were

studied

an

unusually

(22).

(T2), of

very

close

tissue

longitudinal the

3,000

(r

levels

ranging

j.tg/g.

These

meen-

rate

relationship

correlation

iron

trans-

surprisingly

of the 12 relaxation a linear

exlarge

of

with

iron-

ex vivo These

Furthermore,

showed

to

problems

signal-to-noise

enhancement

little

MR

tissue.

spectrometer

relaxation

calcurequen-

mechanism signal

livers

selective

with

to

Ti, time,

from

iron-overloaded this

12,

that

technical

revealed

(1 /12)

At

radio-f

other

verse

and

altered.

imperfect

the

I!

.

time and TE density (N11),

by the low

MR

signal

] e

R/T1

impossible to

peniments and

e

due

apparent

spin-echo

parameters

elucidate

laxation

is known to improve long(10). However, clinical

serologic

insensitive

less

bea suc-

therapy. and

in of

be

was

alteration

It was

-

the

this

tissue

repetition that proton

must

overloaded of

low

[1

and

for

determi-

(19). However,

for #{149}

conimage

over

whether

tissue

of

To

chemical

(16).

due

ratios

tissue

a close MR

interest

practically

pulses

a noninva-

content

equation

sig-

stimu-

quantitate

or a related

=

in

(16-21),

between

and

exacerbated

de-

to

known

T2

sible

will

develop

test

iron

(N,1

of

that

In 1983,

liver

these

cy is

to

fibrosis

images

failure,

MR

the

late

hemochromatoof

as

from

it was

pan-

This

such

and/or

that may lead of the patho-

utility

response

the It

finding

pancreatic

subsequent

chromatosis term survival and

cellular

hepatoma.

therapy

clinical on

cessful

of

and

sensitivity

grant

MR

observation understanding

The

Sup-

Re-

reprint requests

of

where TR echo time)

signal

the

iron

risk

and

severe tween

02114.

intensity

nation

intensity

hemochromatosis.

the

parenchymal

Gener-

MA 25,

Institutes

its

Har-

Massachusetts Boston,

Address

R01-CA50353.

the

genesis

of Radiology.

of

relation-

expected

(parenchymal)

pend the Department

From

iron

that

confirm

splenic with

of

cirrhosis,

sis.

I

and

correlated

with

to

qualitative

pancreatic

an important to a better

179:333-335

used

overload. In a diverse with relatively severe

the

causes

liver

resonance

enhancement

1991;

signal

the cause of iron group of patients

intensity

a

shows

de-

can

de-

a reduction liver

shown

not

liver

distribution

761.594

et al (9) pub-

was

to the iron

reticulo-

Hemochromatosis,

concentration.

it was

the

is inferred terms:

iron relation

(5-8).

Radiology

diagnostic

be

that

various

Index

of

of a

development

the

research

sive

than

via

the

issue

means

recognized

caused of

ex-

sub-

is delivered

erythrocytes

by Siegelman

this

and

by

clinical

intensity

lating

is re-

iron

patients

it was

of clinical

organelles.

senescent

of

the

range

is be-

penoxidation,

effects

in

overload

nal

the

which

(12-14).

of liver

a different

resonance (MR) imof organs other

hepatocytes, iron

to initiate

stabilizing

In

in

iron

fraction

cells),

iron

accurately

in

Early

risk,

within

measured

MR imaging,

less

tissue

detection

susceptibility

the magnetic age signal intensity

in

cytosolic

transit

study

at

a greater

toxic

weight

having are

of

are too

for

netoencephalography,

with

overload

imprecise

vice is used to measure liver iron; only two such devices have been available worldwide over the past decade.

con-

of wet

levels

(Kupffer

the

iron

Patients

because

to

The

zg/g

is sequestered

RES

pa-

occur

liver

zg/g). iron

iron

may

total

iron

lished

he-

increase

low-molecular-weight

iron

at

of 5,000

total

in

hemochnomato-

hepatoma