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Hemochromatosis Imaging

Practice Essentials

Hemochromatosis is characterized by a progressive increase in total body iron stores, with abnormal iron deposition in multiple organs.
Primary hemochromatosis is a genetic disorder, whereas secondary hemochromatosis can be the result of a variety of disorders, most commonly chronic hemolytic anemias.

Preferred examination

Magnetic resonance imaging (MRI) is the best imaging examination to evaluate abnormal iron deposition in the liver. Computed tomography (CT) scanning is less sensitive than MRI but can demonstrate increased iron if it is severe. Although quantification of iron deposition in the liver is possible with MRI, calibration of each MR scanner is necessary. Therefore, quantitative MRI for iron deposition is not available at many institutions.
 Iron deposits in the liver usually do not alter liver echogenicity. If ultrasonographic liver abnormalities are present, they are usually secondary to cirrhosis. An echogenic pancreas has been described with iron deposition.

(See the images below.)

T2-weighted gradient echo axial image in a patient

T2-weighted gradient echo axial image in a patient with hemochromatosis demonstrates diffuse abnormal low signal intensity of the liver. The pancreas and spleen appear normal.

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Noncontrast CT scan in a 47-year-old man with sick

Noncontrast CT scan in a 47-year-old man with sickle cell disease who had undergone multiple transfusions demonstrates diffuse increased attenuation of the liver, representing abnormal iron deposition. The spleen is small and calcified from autosplenectomy.

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