Looking for IRON on the CT scan, Xray, MRI, etc.
Click on the titles to read links on these test procedures
 & to see radiology reports and pictures.

• Abnormal accumulation of iron in the liver, view of a slide at Michigan State University website

• A middle aged man with diabetes mellitus and a liver mass. Steven Eliason, M.D., Elizabeth M. Brunt, M.D., Bruce R. Bacon, M.D., Leonard E. Grosso, M.D., Ph.D.  SLUCARE PathLab Case of the Month  

• Cardiac hemochromatosis: beneficial effects of iron removal therapy. An echocardiographic study. Statistically significant increases in left ventricular (LV) mass, end-diastolic and end-systolic diameters of the left ventricle and in left atrial dimension were observed in patients with IH; significant changes of systolic function indexes (decrease in fractional shortening and ejection fraction and increase in distance of the E point to the septum) were seen as well.  Am J Cardiol 1983 Oct 1

• Cirrhosis of the liver as a precancerous condition 
  Schweiz Rundsch Med Prax 1998 Oct 28 Patients suffering from cirrhosis of the liver due to HBV-, HCV- or HDV-infection and patients with genetic hemochromatosis exhibit a high risk for HCC.

• Coinheritance of alleles associated with hemochromatosis and hereditary hyperferritinemia-cataract syndrome.
  Blood. 1998 Dec 1 Barton JC, Beutler E, Gelbart T  CT scanning suggested that far more iron was stored in our patient's liver than could be mobilized by phlebotomy, indicating that this noninvasive technique lacks sufficient sensitivity for the measurement of normal or near-normal quantities of hepatic iron [This patient was a HIS het. with high ferritin, but normal TS .  The ferritin was not decreased with phlebs.]

• Correlation between the depth of inverted T waves and the serum level of ferritin in a deferoxamine-treated patient with primary hemochromatosis and hyperthyroidism.   Jpn J Med. 1989 Mar-Apr There seemed to be a correlation between the depth of inverted T waves and the serum level of ferritin.

• Diagnosis of hemochromatosis with magnetic resonance   An Med Interna 2000 Aug; MRI can be useful in the evaluation of hemochromatosis among patients who refuse or have contraindication to liver biopsy.

• Diagnosis of liver cirrhosis in children based on colour Doppler ultrasonography with histopathological correlation.    Pediatr Radiol 1998 Nov  Portal vein velocity, arterio-portal vein ratio and hepatic artery visualisation together were reliable in diagnosis of cirrhosis in the paediatric age group

• Diagnosis of neonatal hemochromatosis with MR imaging and duplex Doppler sonography   Publication Date 11/23/1999  With the help of MRI, plus increasing awareness of the disorder, diagnosis is now often made early, even in utero. Duplex Doppler sonography does not provide information on siderosis but shows abnormalities in the liver or blood-flow patterns associated with liver disease.

• Evaluation and interpretation of iron in the liver 
  Semin Diagn Pathol 1998 Nov  Because homozygosity for the C282Y mutation is diagnostic of the condition regardless of the liver iron concentration-to-age ratio, indication for liver biopsy in C282Y homozygotes is restricted to the assessment of prognostic lesions, such as fibrosis and iron-free-foci.

• Evaluation of bone marrow iron by magnetic resonance imaging.
  Ann Hematol 1997 Jun These observations suggest that MRI may be a useful and noninvasive method for systemic quantitative determination of bone marrow iron.

• Families Who Made A Difference Genetic Health By Lois Baron  December 28, 2000

• Gamna-Gandy bodies of the spleen detected with MR imaging. A case report.   
  Magn Reson Imaging 2001 Nov In this case, MR imaging revealed small siderotic nodules of the spleen, called Gamna-Gandy bodies. These lesions are found in patients with portal vein or splenic vein thrombosis, hemolytic anemia, leukemia, or lymphoma, patients receiving blood transfusions, acquired hemochromatosis, or paroxysmal nocturnal hemoglobinuria.

• Getting iron out   Pittsburgh Post-Gazette Tuesday, November 10, 1998

• Hand and wrist arthropathies of hemochromatosis and calcium pyrophosphate deposition disease: distinct radiographic features Radiology 1983 May; Radiographic features of hand and wrist involvement in 26 patients with hemochromatosis and in 26 patients with idiopathic calcium pyrophosphate dihydrate (CPPD) crystal deposition disease were compared.

• Hemochromatosis eMedicine Journal, December 7 2001, Volume 2, Number 12, Authored by Sandor Joffe, MD, Section Chief of Abdominal Imaging, Department of Radiology, Beth Israel Medical Center  This article covers the pathophysiology of hemochromatosis as well as the techniques in using ULS, CT & MRI to identify iron deposition in the organs. Pictures & descriptions from scans of the abdomen are shown.

• Hemochromatosis 
  Gale Encyclopedia of Medicine The symptoms of hemochromatosis include fatigue, weight loss, weakness, shortness of breath, heart palpitations, chronic abdominal pain, and impaired sexual performance. The patient may also show symptoms commonly connected with heart failure, diabetes or cirrhosis of the liver. Changes in the pigment of the skin may appear, such as grayness in certain areas, or a tanned or yellow (jaundice) appearance.

• Hemochromatosis of the pituitary gland: MR imaging 
  Radiology, Vol 168, 213-214 1988 Magnetic resonance imaging of the pituitary gland in a patient with secondary hemochromatosis is described. On T1-weighted images, the anterior lobe had almost no signal intensity, and only the high-signal posterior lobe was seen. These findings are compatible with the distribution of iron deposition and clinical symptoms in hemochromatosis.

• Hemochromatosis:  Slide presentation  
  by Keith Kaplan MD, Walter Reed Army Medical Center

• Hepatic Pathology Index Images of normal & diseased livers.

• HEPATOCELLULAR CARCINOMA  
  MRI is superior to CT in demonstrating the fibrous capsule seen in 50% of the hepatomas and in delineating the tumor margin and venous invasion.  Images of the liver by CT & MRI.

• Hereditary haemochromatosis: a case of iron accumulation in the basal ganglia associated with a parkinsonian syndrome: J Neurol Neurosurg Psychiatry 1995 Sep Hereditary haemochromatosis should be considered in the differential diagnosis of parkinsonian syndromes, because complications of iron induced organ injury may be prevented by phlebotomy.

• Hip arthropathy in genetic hemochromatosis. Radiographic and histologic features
  In this study, hip radiographs of 112 patients with genetic hemochromatosis and arthritis were reviewed, and histologic examination of 2 femoral heads was performed.  Arthritis Rheum 1991 Mar

• Imaging Diagnosis of Hepatocellular Carcinoma and Premalignant/Borderline Lesions 
  Sem Liver Disease 19(3):297-309, 1999   Early detection of hepatocellular carcinoma (HCC) has improved with recent noninvasive imaging modalities, such as ultrasonography (US), computer tomography (CT), and magnetic resonance imaging (MRI).

• LIVER, GALL BLADDER, & PANCREAS
  Thomas A. Godwin, M.D.Department of Pathology  1995, Cornell University Medical College  Descriptions of various diseases affecting these organs as well as pathology slides.

• Magnetic resonance imaging of the liver: current clinical applications.
  Mayo Clin Proc 1993 Feb.  Magnetic resonance imaging provides excellent anatomic depiction of the liver and important information about focal and diffuse diseases that affect this organ.

• Magnetic resonance imaging of the pituitary gland in patients with secondary hypogonadism due to transfusional hemochromatosis. 
  MAGMA. 1999 May  The lower the signal intensity of the pituitary gland, the greater the serum ferritin level.  The detection of pituitary iron overload on GRE T2*-weighted images is consistent with the hypothesis of hypogonadotrophic pituitary insufficiency due to iron-induced cellular damage.

• Magnetic resonance iron-free nodules in genetic hemochromatosis.
  Am J Gastroenterol. 1999 Apr  The present data confirm the high prevalence of liver cancer at the time of diagnosis, mainly in cirrhotic patients greater than 45 years of age, and indicate that, when performing MRI for liver iron quantification, a complete hepatic MRI examination is preferable to a simple signal measurement in patients at risk for hepatocellular carcinoma.
   

• Metabolic arthropathies
  The clinical and radiologic presentations of the arthropathy of hemochromatosis have been extensively reviewed. Screening for the disease appears important, because it is the only way to prevent progressive worsening of organ involvement and arthropathy in particular. Curr Opin Rheumatol 1994 Jul.

• MRI evaluation of brain iron in earlier- and later-onset Parkinson's 
  Magn Reson Imaging 1999 Feb The FDRI results suggest that disregulation of iron metabolism occurs in PD and that this disregulation may differ in earlier- versus later-onset PD.

• MR imaging of the thyroid and parathyroid glands. 
  Magn Reson Imaging Clin N Am. 2000 Feb MR imaging also has been used for the investigation of congenital disorders of the thyroid gland and the evaluation of diffuse thyroid disease, such as Grave's disease, Hashimoto's and Riedel thyroiditis, and hemochromatosis

• MR imaging of thyroid hemochromatosis.
  J Comput Assist Tomogr. 1988 Jul-Aug  We present the magnetic resonance (MR) images of exogenous hemochromatosis in the thyroid gland. On both T1-weighted images and T2-weighted images the thyroid showed low intensity similar to that of the background. Magnetic resonance is of value in imaging the tissue deposition of iron. In assessing thyroid iron accumulation, MR is superior to CT because CT can not differentiate iron deposition from normal iodine concentration.

• Non-invasive assessment of tissue iron overload in the liver by magnetic resonance imaging.
  Br J Haematol. 1994 May . It is concluded that MRI based on SIR measurements offers a precise and reproducible non-invasive method for the determination and follow-up of iron overload within a wide range of liver iron concentrations. Our findings may increase the clinical use of MRI in haematological patients with iron overload.
   
• Pathology Cases for Diagnosis: A 37 year old male is referred to the liver clinic for evaluation of abnormal liver related enzymes.  Includes pictures of biopsy slides. Case 96-19: Liver II Contributed by D. Robert Dufour, M.D., CAPT, MC, USNR-R Date Available: July 22, 1996 - December 31, 1996 

• Pituitary gland. Variable signal intensities on MRI. A pictorial essay.
  Clin Imaging. 1998 Sep-Oct Low T2w signal may be seen in hemorrhage, calcification, cystic lesion, hemochromatosis, melanoma, and vascular lesions. These are described and illustrated.

• Potential MR pitfall in relying on lesion/liver intensity ratio in presence of hepatic hemochromatosis. 
   J Comput Assist Tomogr. 1988 Mar-Apr; Mirowitz S, Heiken JP, Lee JK. Department of Radiology, Jewish Hospital of St. Louis, Washington University Medical Center, MO. We present a case of hepatic metastasis studied by magnetic resonance imaging in which a spuriously high lesion/liver intensity ratio (suggestive of cavernous hemangioma) was obtained due to underlying hemochromatosis.

• Primary hemochromatosis: anatomic and physiologic characteristics of the cardiac ventricles and their response to phlebotomy  Am J Cardiol 1984 Jul 1  Primary hemochromatosis can effect LV and RV size and function; clinically occult cardiac involvement can be identified by echocardiography and equilibrium blood pool imaging; therapeutic phlebotomy can ameliorate or reverse the deleterious effects of excess cardiac iron deposition.

• Quantitative Texture Analysis in Two-Dimensional Echocardiography: Application to the Diagnosis of Myocardial Hemochromatosis.Echocardiography.
  1996 Jan Myocardial walls affected by hemochromatosis show ultrasound image texture alterations that may be quantified with digital image analysis techniques and appear mostly unrelated to hematologic and conventional, as well as radiofrequency-based, echocardiographic parameters. These changes in quantitatively evaluated echo reflectivity are present even before the development of clinical and echocardiographic signs of cardiac dysfunction.

• Radiological features of the visceral and skeletal involvement of hemochromatosis 
  European Radiology Abstract Volume 7 Issue 8 (1997) pp 1199-1206 Hemochromatosis arthropathy includes degenerative osteoarthritis and chondrocalcinosis.

• Recent scientific advances in neurogenetics, Friedreich's Ataxia, iron & yeast 
  A brain imaging technique has shown that iron levels are indeed selectively elevated in the brains of patients with Friedreich's, suggesting that targeting iron metabolism may help treat the disease.

• Rheumatic manifestations of haemochromatosis
  Baillieres Clin Rheumatol 1991 Aug The characteristic histological changes are: abnormal amounts of iron deposits, little or no signs of synovial inflammation and CPPD deposition.

• Should all patients with diabetes mellitus be screened for hemochromatosis?   Department of Family Medicine University of California, Los Angeles 924 Westwood Blvd, Suite 650 Los Angeles, CA 90095-1628  West J Med 2002;176:110-114  Enhanced case finding becomes the first stage in a public health response when evidence has emerged for an effective early treatment of a disorder. It means the detection of HHC at the time of early symptoms, and it allows patients to benefit from early phlebotomy.  The implementation of this approach would include adding fasting serum transferrin saturation to the usual workup of patients with newly diagnosed diabetes mellitus, arthritis, and impotence.  The CDC recommends such iron-overload testing in anyone with possible symptoms of hemochromatosis, which includes patients with newly diagnosed diabetes mellitus. [Abdominal computed tomographic scan showing a normal pancreas and a nonspecific, homogeneously slightly increased density found throughout the liver.]

• Spontaneous multiple vertebral fractures revealed primary haemochromatosis  We describe a male patient with osteoporotic fractures as a presenting feature of haemochromatosis  Osteoporos Int 1996

• T1 and T2 in the brain of healthy subjects, patients with Parkinson disease, and patients with multiple system atrophy: relation to iron content  Radiology. 1999;  In conclusion, the results of this study confirm and extend earlier reports of the linear relation between MR signal and iron content in iron-containing deep nuclei. This study is more robust in that both T1 and T2 changes are used, providing a more specific and accurate determination of changes in iron content and form.

• The diagnostic value of bone marrow iron.
  Folia Haematol Int Mag Klin Morphol Blutforsch 1990  In detail, the patterns of iron storage in the bone-marrow are described in the different stages of iron deficiency, disturbance of iron utilization in chronically inflammatory processes or tumour diseases, condition after intravenous iron administration, transfusion siderosis, hereditary haemochromatosis and sideroblastic anaemia.

• The Urbana Atlas of Pathology 
  University of Illinois College of Medicine at Urbana-Champaign  Overview of slides & annotations.

• Vital Signs: Beyond the Glass  A pathologist is often part detective. And the evidence is often only small bits of tissue-and history DISCOVER Vol. 19 No. 9 (September 1998)

• Yersinia enterocolitica infection with multiple liver abscesses uncovering a primary hemochromatosis. Scand J Gastroenterol 2001 Feb  In conclusion, severe septic forms of yersiniosis are mainly found in patients with iron overload, due to a handicapped iron metabolism of the Yersinia bacteria. Mortality is high despite treatment.

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