In patients with liver iron overload related to primary (genetic) or secondary hemochromatosis [1,2],
the risk for developing fibrosis and cirrhosis has been associated to the liver iron content (liver iron concentration [LIC]),
the duration of iron exposure by the liver,
and the presence of co-factors of hepatotoxicity,
such as viruses and alcohol [3,4].
Liver biopsy is still considered the gold-standard method for evaluating the stage of hepatic fibrosis and to measure LIC in patients with...
Methods and materials
Patient inclusion: This was a prospective monocentric study and patient’s enrollment was performed at the Unit of Microcitemia and Hereditary Anaemias of our Institution,
where subjects with different diseases leading to liver iron overload are routinely evaluated with MRI.
Consecutive patients with MRI T2* detectable hepatic iron (liver T2*value≤6.3 ms) were enrolled into the study.
The study protocol was approved by the institutional review board.
Written informed consent was obtained from...
Sixty-seven patients met the inclusion criteria.
Seven patients were excluded: both TE and RTE were unsuccessful because of narrow intercostal spaces in 2 cases,
and BMI > 27.5 kg/m2in other 3 cases; in the remaining 2 patients TE measurements had an IQR > 30%.
The resulting 60 patients were 34 males (56.7%),
26 females (43.3%) with a median age of 42 (21–76) years and a mean BMI of 23.83±3.67.
They included 37 adult homozygous-β-thalassemic patients (thalassemia major),
Liver biopsy remains the reference method in order to determine the grade of fibrosis in chronic liver diseases,
but it is an invasive and painful procedure,
which can study only 1/50,000 of the total volume of the liver [5,10,19].
Liver biopsy has also several complications related to its invasiveness (e.g.
patient’s dis-comfort and bleeding),
and an overall procedure-related mortality of 1/1000–10,000 .
A heterogeneous distribution of fibrosis in the liver may become a limitation for...
 Pietrangelo A.
2):ii23–30.  Siah CW,
Normal iron metabolism and the pathophysiology of iron overload disorders.
Clin Biochem Rev2006;27(1):5–16.  Olynyk JK,
St Pierre TG,
Duration of hepatic iron exposure increases the risk of significant fibrosis in hereditary hemochromatosis: a new role for magnetic resonance imaging.
Am J Gastroenterol2005;100(4):837–41.  Wood MJ,...