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Gastroenterology and Hepatology - Infectious Diseases - Pathology - Radiology and Medical Imaging

Quantification of Hepatic Iron Concentration in Chronic Viral Hepatitis: Usefulness of T2-weighted Single-Shot Spin-Echo Echo-Planar MR Imaging
Published: Friday, March 16, 2012
Author: Tatsuyuki Tonan et al.

by Tatsuyuki Tonan, Kiminori Fujimoto, Aliya Qayyum, Takumi Kawaguchi, Atsushi Kawaguchi, Osamu Nakashima, Koji Okuda, Naofumi Hayabuchi, Michio Sata


To investigate the usefulness of single-shot spin-echo echo-planar imaging (SSEPI) sequence for quantifying mild degree of hepatic iron stores in patients with viral hepatitis.


This retrospective study included 34 patients with chronic viral hepatitis/cirrhosis who had undergone histological investigation and magnetic resonance imaging with T2-weighted gradient-recalled echo sequence (T2-GRE) and diffusion-weighted SSEPI sequence with b-factors of 0 s/mm2 (T2-EPI), 500 s/mm2 (DW-EPI-500), and 1000 s/mm2 (DW-EPI-1000).The correlation between the liver-to-muscle signal intensity ratio, which was generated by regions of interest placed in the liver and paraspinous muscles of each sequence image, and the hepatic iron concentration (µmol/g dry liver), which was assessed by spectrophotometry, was analyzed by linear regression using a spline model. Akaike information criterion (AIC) was used to select the optimal model.


Mean ± standard deviation of the hepatic iron concentration quantified by spectrophotometry was 24.6±16.4 (range, 5.5 to 83.2) µmol/g dry liver. DW-EPI correlated more closely with hepatic iron concentration than T2-GRE (R square values: 0.75 for T2-EPI, 0.69 for DW-EPI-500, 0.62 for DW-EPI-1000, and 0.61 for T2-GRE, respectively, all P<0.0001). Using the AIC, the regression model for T2-EPI generated by spline model was optimal because of lowest cross validation error.


T2-EPI was sensitive to hepatic iron, and might be a more useful sequence for quantifying mild degree of hepatic iron stores in patients with chronic viral hepatitis.