MR characterization of hepatic storage iron in transfusional iron overload

J Magn Reson Imaging. 2014 Feb;39(2):307-16. doi: 10.1002/jmri.24171. Epub 2013 May 29.


Purpose: To quantify the two principal forms of hepatic storage iron, diffuse, soluble iron (primarily ferritin), and aggregated, insoluble iron (primarily hemosiderin) using a new MRI method in patients with transfusional iron overload.

Materials and methods: Six healthy volunteers and 20 patients with transfusion-dependent thalassemia syndromes and iron overload were examined. Ferritin- and hemosiderin-like iron were determined based on the measurement of two distinct relaxation parameters: the "reduced" transverse relaxation rate, RR2 , and the "aggregation index," A, using three sets of Carr-Purcell-Meiboom-Gill (CPMG) datasets with different interecho spacings. Agarose phantoms, simulating the relaxation and susceptibility properties of tissue with different concentrations of dispersed (ferritin-like) and aggregated (hemosiderin-like) iron, were used for validation.

Results: Both phantom and in vivo human data confirmed that transverse relaxation components associated with the dispersed and aggregated iron could be separated using the two-parameter (RR2 , A) method. The MRI-determined total hepatic storage iron was highly correlated (r = 0.95) with measurements derived from biopsy or biosusceptometry. As total hepatic storage iron increased, the proportion stored as aggregated iron became greater.

Conclusion: This method provides a new means for noninvasive MRI determination of the partition of hepatic storage iron between ferritin and hemosiderin in iron overload disorders.

Keywords: MRI; ferritin, hemosiderin, iron quantification; hepatic storage iron; iron overload.

Publication types

  • Controlled Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Iron / metabolism
  • Iron / pharmacokinetics
  • Iron Overload / diagnosis*
  • Iron Overload / etiology
  • Iron Overload / metabolism*
  • Liver / metabolism
  • Liver Diseases / diagnosis*
  • Liver Diseases / metabolism*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Thalassemia / metabolism*
  • Thalassemia / therapy
  • Tissue Distribution
  • Transfusion Reaction


  • Iron