Hepatic Iron Deposition in Patients With Liver Disease: Preliminary Experience With Breath-Hold Multiecho T2*-Weighted Sequence

OBJECTIVE. The purpose of this study was to conduct, using histopathologic examination as the reference standard, a preliminary evaluation of the use of a breath-hold multiecho T2*-weighted MRI sequence in the detection and quantification of hepatic iron deposition in patients with liver disease. MATERIALS AND METHODS. The images of 43 patients with liver disease who underwent 1.5-T MRI of the liver that included a multiecho T2*-weighted sequence who also underwent concomitant liver biopsy or liver transplantation were assessed. Two independent observers measured hepatic T2* by placing regions of interest in the hepatic parenchyma. Hepatic T2* values were compared between patients stratified by hepatic iron grade and were correlated with histopathologic iron grade. Receiver operating characteristics analysis was performed to assess the accuracy of images obtained with the hepatic T2*-weighted sequence in the diagnosis of iron deposition. RESULTS. Patients with iron deposition had shorter hepatic T2* values than did patients without iron deposition (mean T2*, 17.7 vs 32.3 milliseconds with pooled data from both observers; p < 0.0001). Patients with iron grade 3 or greater had shorter T2* values than those with iron grade 2 or less (10.1 vs 20.8 milliseconds; p < 0.0001). There was a strong negative correlation between hepatic T2* and histopathologic iron grade (r = -0.849; p < 0.0001). For the prediction of iron grades 1 or greater and 3 or greater, area under the curve, sensitivity, and specificity were 0.968-0.982, 90.5-100%, and 100-97.3% at T2* cutoffs of less than 24 and less than 14 milliseconds, respectively. CONCLUSION. Hepatic iron overload in patients with liver disease can be assessed rapidly and accurately with MRI performed with a breath-hold T2*-weighted sequence.