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Hepatocellular Carcinoma: Association with Increased Iron Deposition in the Cirrhotic Liver at MR Imaging1

Katsuyoshi Ito, MD, Donald G. Mitchell, MD, Toshifumi Gabata, MD, Hie-Won L. Hann, MD, Pyo N. Kim, MD, Takeshi Fujita, MD, Hitomi Awaya, MD, Kazumitsu Honjo, MD and Naofumi Matsunaga, MD

1 From the Department of Radiology, Thomas Jefferson University Hospital, 132 S 10th St, 1096 Main Bldg, Philadelphia, PA 19107 (K.I., D.G.M., T.G., P.N.K.); the Department of Radiology, Kanazawa University School of Medicine, Kanazawa, Japan (T.G.); the Department of Medicine, Jefferson Medical College, Philadelphia, Pa (H.W.L.H.); and the Department of Radiology, Yamaguchi University School of Medicine, Yamaguchi, Japan (T.F., H.A., K.H., N.M.). Received June 30, 1998; revision requested August 5; revision received September 29; accepted January 19, 1999. Address reprint requests to D.G.M. (e-mail: Donald.Mitchell@mail.tju.edu).



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  		Figure 1a. Cirrhosis without hepatic iron deposition in an 84-year-old woman. (a) Axial T2-weighted fast SE image (6,000/144) demonstrates normal liver signal intensity, which is higher than the signal intensity of the skeletal muscle (M). (b) Axial GRE image (32/8.7, 45° flip angle) shows normal liver signal intensity, which is higher than that of the spleen (S) and the skeletal muscle, consistent with no hepatic iron deposition.

 


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  		Figure 1b. Cirrhosis without hepatic iron deposition in an 84-year-old woman. (a) Axial T2-weighted fast SE image (6,000/144) demonstrates normal liver signal intensity, which is higher than the signal intensity of the skeletal muscle (M). (b) Axial GRE image (32/8.7, 45° flip angle) shows normal liver signal intensity, which is higher than that of the spleen (S) and the skeletal muscle, consistent with no hepatic iron deposition.

 


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  		Figure 2. Cirrhosis with hepatic parenchymal iron deposition in a 59-year-old man. Axial GRE image (33/8.7, 45° flip angle) shows the liver with low signal intensity compared with the skeletal muscle. Siderotic nodules (arrow) are present in the spleen.

 


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  		Figure 3a. Cirrhosis with iron deposition in hepatic regenerative nodules in a 54-year-old man. (a) Axial T2-weighted SE image (2,000/50) demonstrates small low-intensity nodules (arrows) in the liver. (b) Axial GRE image (33/8.7, 45° flip angle) clearly shows multiple low-intensity nodules (arrows) in the liver, which are consistent with siderotic regenerative nodules.

 


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  		Figure 3b. Cirrhosis with iron deposition in hepatic regenerative nodules in a 54-year-old man. (a) Axial T2-weighted SE image (2,000/50) demonstrates small low-intensity nodules (arrows) in the liver. (b) Axial GRE image (33/8.7, 45° flip angle) clearly shows multiple low-intensity nodules (arrows) in the liver, which are consistent with siderotic regenerative nodules.

 


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  		Figure 4a. Cirrhosis with HCC and iron deposition in hepatic regenerative nodules in a 68-year-old man. (a) Axial T2-weighted fast SE image (2,500/99) and (b) axial GRE image (150/6, 60° flip angle) show multiple siderotic regenerative nodules (arrowheads) with low signal intensity. (c) Axial arterial-phase contrast-enhanced dynamic GRE image (150/6, 60° flip angle) demonstrates HCC as a nodule (arrow) with early enhancement.

 


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  		Figure 4b. Cirrhosis with HCC and iron deposition in hepatic regenerative nodules in a 68-year-old man. (a) Axial T2-weighted fast SE image (2,500/99) and (b) axial GRE image (150/6, 60° flip angle) show multiple siderotic regenerative nodules (arrowheads) with low signal intensity. (c) Axial arterial-phase contrast-enhanced dynamic GRE image (150/6, 60° flip angle) demonstrates HCC as a nodule (arrow) with early enhancement.

 


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  		Figure 4c. Cirrhosis with HCC and iron deposition in hepatic regenerative nodules in a 68-year-old man. (a) Axial T2-weighted fast SE image (2,500/99) and (b) axial GRE image (150/6, 60° flip angle) show multiple siderotic regenerative nodules (arrowheads) with low signal intensity. (c) Axial arterial-phase contrast-enhanced dynamic GRE image (150/6, 60° flip angle) demonstrates HCC as a nodule (arrow) with early enhancement.

 




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