Liver iron content assessment by routine and simple magnetic resonance imaging procedure in highly transfused patients

Eur J Haematol. 2006 Aug;77(2):145-9. doi: 10.1111/j.0902-4441.2006.t01-1-EJH2571.x. Epub 2006 Apr 11.


Background: Liver iron content (LIC) assessment by magnetic resonance imaging (MRI) is validated but not standardized. In a single center, we tried to assess the accuracy of a specific, simple MRI procedure adapted to high LIC from a well-established simple and routine procedure known to quantify LIC.

Methods: In 27 cases of monthly transfused patients, we compared biochemical values of LIC assessed on liver biopsy specimens and results obtained by two signal intensity ratio of gradient echo imaging (R2*) MRI protocols. The first was Gandon's routine procedure previously validated in liver disease and the second, our own method, was an addition of a gradient echo sequence specifically adapted to high LIC encountered in hematology practice.

Results: Twenty-seven liver biopsies were performed in 18 adult patients (myelodysplastic syndrome = 5, beta-thalassemia = 13). LIC by biopsy ranged from 1.4 to 54 mg/g liver dry weight (mg/g dw) (median 9.4 mg/g dw). Correlation between LIC by biopsy and by MRI with Gandon's procedure was good (R = 0.80) in patients with LIC falling within the range reported by Gandon. By contrast, a weak correlation was demonstrated (R = 0.52) in patients with high LIC (above 11.2 mg/g dw). With our sequences, the correlation was good both in the entire group of patients (R = 0.83) and in patients with LIC above 11.2 mg/g dw (R = 0.85).

Conclusion: Our results suggest that the addition of a specific shorter-gradient echo sequence to a very simple, fast technique produces an accurate estimation of LIC in post-transfusional iron overload.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biopsy
  • Female
  • Humans
  • Iron / analysis*
  • Iron Overload / diagnosis*
  • Iron Overload / metabolism
  • Iron Overload / pathology
  • Liver / chemistry*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / pathology
  • Myelodysplastic Syndromes / therapy
  • Transfusion Reaction*
  • beta-Thalassemia / pathology
  • beta-Thalassemia / therapy


  • Iron