Abstract

SPINA, J.C. et al. Valoración no invasiva de la sobrecarga hepática de hierro en pacientes con hemocromatosis. Rev. argent. radiol. [online]. 2014, vol.78, n.1, pp.22-29. ISSN 1852-9992.  http://dx.doi.org/10.7811/rarv78n1a05.

Our purpose is to analyze the metabolism and pathophysiology of iron deposition, to describe the usefulness of magnetic resonance imaging (MRI) in the estimation of hepatic iron overload using specific sequences, and to review the different pathologies leading to iron overload of the abdominal organs and its presentation in MRI. Iron overload in the liver may be due to a genetic condition (primary hemo chromatosis), or due to multiple blood transfusions and chronic diseases like increased absorption, myelodysplasia, thalassemia, etc. (secondary hemochromatosis). MRI is a noninvasive method to detect the presence of iron overload and to monitor treatment after diagnosis, avoiding repeated biopsies. This is due to the paramagnetic properties of iron accumulation in the tissues causing local distortion in the magnetic field. This phenomena is seen as a reduction of the MRI signal in the affected organs, being directly proportional to the amount of iron deposited. The conventional in phase and out of phase MRI sequences can show iron deposition in liver, spleen and pancreas, although milder forms may go undetected if more sensitive sequences, like gradient echo sequence, are not used, according to the technique proposed by Gandon et al., which can estimate quantitatively the severity of iron deposition. Iron deposition can show a reticuloendothelial type pattern (secondary to multiple transfusions where iron deposits in the liver, spleen and bone marrow without tissue damage), a parenchymal pattern (involving the liver and pancreas) and a mixed pattern. MRI has a fundamental role in the diagnosis of hemochromatosis, especially in subclinical phase. It helps to stratify the severity of hepatic iron overload and assess response to treatment, avoiding invasive procedures.

Keywords : Iron; Hemochromatosis; Magnetic resonance imaging; Gradient echo.

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