European Radiology

, Volume 22, Issue 11, pp 2478–2486

Evaluation of MR imaging with T1 and T2* mapping for the determination of hepatic iron overload

  • B. Henninger
  • C. Kremser
  • S. Rauch
  • R. Eder
  • H. Zoller
  • A. Finkenstedt
  • H. J. Michaely
  • M. Schocke
Gastrointestinal

DOI: 10.1007/s00330-012-2506-2

Cite this article as:
Henninger, B., Kremser, C., Rauch, S. et al. Eur Radiol (2012) 22: 2478. doi:10.1007/s00330-012-2506-2

Abstract

Objectives

To evaluate MRI using T1 and T2* mapping sequences in patients with suspected hepatic iron overload (HIO).

Methods

Twenty-five consecutive patients with clinically suspected HIO were retrospectively studied. All underwent MRI and liver biopsy. For the quantification of liver T2* values we used a fat-saturated multi-echo gradient echo sequence with 12 echoes (TR = 200 ms, TE = 0.99 ms +  n × 1.41 ms, flip angle 20°). T1 values were obtained using a fast T1 mapping sequence based on an inversion recovery snapshot FLASH sequence. Parameter maps were analysed using regions of interest.

Results

ROC analysis calculated cut-off points at 10.07 ms and 15.47 ms for T2* in the determination of HIO with accuracy 88 %/88 %, sensitivity 84 %/89.5 % and specificity 100 %/83 %. MRI correctly classified 20 patients (80 %). All patients with HIO only had decreased T1 and T2* relaxation times. There was a significant difference in T1 between patients with HIO only and patients with HIO and steatohepatitis (P = 0.018).

Conclusions

MRI-based T2* relaxation diagnoses HIO very accurately, even at low iron concentrations. Important additional information may be obtained by the combination of T1 and T2* mapping. It is a rapid, non-invasive, accurate and reproducible technique for validating the evidence of even low hepatic iron concentrations.

Key Points

Hepatic iron overload causes fibrosis, cirrhosis and increases hepatocellular carcinoma risk.

MRI detects iron because of the field heterogeneity generated by haemosiderin.

T2* relaxation is very accurate in diagnosing hepatic iron overload.

Additional information may be obtained by T1 and T2* mapping.

Keywords

Magnetic resonance imagingMRILiverFatty liverHemochromatosisHepatic ironIron overloadT2*T1

Abbreviations

HH

hereditary haemochromatosis

HII

hepatic iron index

HIC

hepatic iron concentration

HIO

hepatic iron overload

LIC

liver iron concentration

MRI

magnetic resonance imaging

SH

steatohepatitis

Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • B. Henninger
    • 1
  • C. Kremser
    • 1
  • S. Rauch
    • 1
  • R. Eder
    • 1
  • H. Zoller
    • 2
  • A. Finkenstedt
    • 2
  • H. J. Michaely
    • 3
  • M. Schocke
    • 1
  1. 1.Department of RadiologyInnsbruck Medical UniversityInnsbruckAustria
  2. 2.Department of Internal MedicineInnsbruck Medical UniversityInnsbruckAustria
  3. 3.Institute of Clinical Radiology and Nuclear Medicine, University Medical Center MannheimMedical Faculty Mannheim – Heidelberg UniversityMannheimGermany