The utility of magnetic resonance imaging (MRI) in diagnosing hemosiderosis of long term hemodialysis patients

The utility of magnetic resonance imaging (MRI) in diagnosing hemosiderosis (H) was evaluated in patients on long-term hemodialysis. The study subjects were 19 patients with serum ferritin (Ft) ≥300μg/l and 4 patients with Ft<300μg/l served as controls, for a total of 23 patients on long-term hem...

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Published inJournal of Japanese Society for Dialysis Therapy Vol. 25; no. 10; pp. 1109 - 1112
Main Authors Taniguchi, Toshio, Nishi, Osamu, Akagaki, Youji, Murata, Tamaki, Uchino, Hitomi, Sako, Mamoru
Format Journal Article
LanguageJapanese
Published The Japanese Society for Dialysis Therapy 1992
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ISSN0911-5889
1884-6211
1884-6211
DOI10.4009/jsdt1985.25.1109

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Abstract The utility of magnetic resonance imaging (MRI) in diagnosing hemosiderosis (H) was evaluated in patients on long-term hemodialysis. The study subjects were 19 patients with serum ferritin (Ft) ≥300μg/l and 4 patients with Ft<300μg/l served as controls, for a total of 23 patients on long-term hemodialysis receiving MRI examination. As a result, the intensity of the liver was diffusely reduced on T2 images in all 19 patients with Ft≥300μg/l The severity of hemosiderosis was divided into groups designated 0 to III according to the degree of siderosis as evaluated by MRI. In a patient of severity I, the T1 image was normal and the intensity was reduced only on the T2 image. In a patient of severity III, the intensity was reduced on both T1 and T2 images. On the other hand, both T1 and T2 images showed normal liver intensity in all 4 controls with Ft<300μg/l. Furthermore, the results of liver function tests including GOT and GPT were normal in all 23 patients. The MRI-assessed severity of H (0 to III) correlated positively with serum Ft and serum Fe. These results suggest that the T1 image is useful for evaluating the severity of H, the T2 image for early diagnosis and that MRI and Ft are useful for evaluating the therapeutic effects on hemosiderosis.
AbstractList The utility of magnetic resonance imaging (MRI) in diagnosing hemosiderosis (H) was evaluated in patients on long-term hemodialysis. The study subjects were 19 patients with serum ferritin (Ft) ≥300μg/l and 4 patients with Ft<300μg/l served as controls, for a total of 23 patients on long-term hemodialysis receiving MRI examination. As a result, the intensity of the liver was diffusely reduced on T2 images in all 19 patients with Ft≥300μg/l The severity of hemosiderosis was divided into groups designated 0 to III according to the degree of siderosis as evaluated by MRI. In a patient of severity I, the T1 image was normal and the intensity was reduced only on the T2 image. In a patient of severity III, the intensity was reduced on both T1 and T2 images. On the other hand, both T1 and T2 images showed normal liver intensity in all 4 controls with Ft<300μg/l. Furthermore, the results of liver function tests including GOT and GPT were normal in all 23 patients. The MRI-assessed severity of H (0 to III) correlated positively with serum Ft and serum Fe. These results suggest that the T1 image is useful for evaluating the severity of H, the T2 image for early diagnosis and that MRI and Ft are useful for evaluating the therapeutic effects on hemosiderosis.
Author Nishi, Osamu
Akagaki, Youji
Murata, Tamaki
Uchino, Hitomi
Sako, Mamoru
Taniguchi, Toshio
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References 7) Addison GM, Beamish MR, Hales CN, Hodygkins M, Jacobs A, Llewellin P: An immunoradiometic assay for ferritin in the serum of normal subjects and patients with iron deficiency and iron overload. J Clin Pathol 25: 326, 1972
1) Pitt TO, Barbour GL: Hemosiderosis secondary to chronic pareteral iron therapy inmaintenance hemodialysis patient. Nephron 22: 316, 1978
2) Kothari T, Swarny AP, Lee JC, Mangla JC: Hepatic Hemosiderosis in maintenance hemodialysis (MTP) patients. Digestive disease end science 25: 363, 1980
5) Stark DD, Moseley ME, Bacon BR, Moss AA, Goldberg HI, Bass NM, James TL: Magnetic resonance imaging and spectroscopy of hepatic iron overload. Radiology 154: 137-142, 1985
13) Chapman RWG, Williams G, Bydder G, Dick R, Sherlock S, Kreel L: Computedtomography for determing liver iron content in primary hemochromatosis. Br Med J 16: 440-442, 1980
3) 吉田英夫, 真野 勇, 浅井佐江, 八代直文, 坂井悠二, 飯尾正宏: Iron strage diseaseのMRI. 臨放 30: 1099-1102, 1985
8) Mirahmadi KS, Paul WL, Winer RL, Dabirvazir H, Bill Byer, Gorman JJ, Rosen SM: Serum ferritin level. Determination of iron requirement in hemodialysis patient. JAMA 238: 601, 1977
10) Moreb J, Popovtzer MM, Friedlaender MM, Konijn AM, Hershko C: Evalvation of iron. Status in patients on chronic hemodialysis: Relative usefulness of bone marrow hemosiderin, serum ferritin, transferrin saturation, mean corpuscular volume and red cell protoporphyrin. Nephron 35: 196-200, 1983
4) Mills SR, Doppman JL, Nienhuis AW: Computed tomography in the diagnosis of disorders ofexcessive iron storage of the liver. Jouval of Computar Assistetomography 1: 101, 1977
6) Brasch RC, Wesbey GE, Goodung CA, Koerpen MA: Magnetic resonance imaiging of transfusional hemosiderosis complicating thalassemia major. Radiology 150: 767-771, 1984
9) Lynn KL, Mitchell TR, Shepperd J: Serum ferritin concentration in patients receiving maintenance hemodialysis. Clinical Nephrology 14: 124, 1980
11) Beallo R, Dallman PR, Schoenfeld PY, Humphreys MH: Serum ferritin and iron deficiency in patients on chronic hemodialysis. Trons Am Soc Artif Intern Organs 22: 73, 1976
12) Brittenhan GM, Danish EH, Harris JW: Assessment of bone marrow and body iron stores: Old techniques and new technologies. Semin Hematol 18: 194-221, 1981
References_xml – reference: 7) Addison GM, Beamish MR, Hales CN, Hodygkins M, Jacobs A, Llewellin P: An immunoradiometic assay for ferritin in the serum of normal subjects and patients with iron deficiency and iron overload. J Clin Pathol 25: 326, 1972
– reference: 4) Mills SR, Doppman JL, Nienhuis AW: Computed tomography in the diagnosis of disorders ofexcessive iron storage of the liver. Jouval of Computar Assistetomography 1: 101, 1977
– reference: 3) 吉田英夫, 真野 勇, 浅井佐江, 八代直文, 坂井悠二, 飯尾正宏: Iron strage diseaseのMRI. 臨放 30: 1099-1102, 1985
– reference: 12) Brittenhan GM, Danish EH, Harris JW: Assessment of bone marrow and body iron stores: Old techniques and new technologies. Semin Hematol 18: 194-221, 1981
– reference: 2) Kothari T, Swarny AP, Lee JC, Mangla JC: Hepatic Hemosiderosis in maintenance hemodialysis (MTP) patients. Digestive disease end science 25: 363, 1980
– reference: 9) Lynn KL, Mitchell TR, Shepperd J: Serum ferritin concentration in patients receiving maintenance hemodialysis. Clinical Nephrology 14: 124, 1980
– reference: 11) Beallo R, Dallman PR, Schoenfeld PY, Humphreys MH: Serum ferritin and iron deficiency in patients on chronic hemodialysis. Trons Am Soc Artif Intern Organs 22: 73, 1976
– reference: 6) Brasch RC, Wesbey GE, Goodung CA, Koerpen MA: Magnetic resonance imaiging of transfusional hemosiderosis complicating thalassemia major. Radiology 150: 767-771, 1984
– reference: 1) Pitt TO, Barbour GL: Hemosiderosis secondary to chronic pareteral iron therapy inmaintenance hemodialysis patient. Nephron 22: 316, 1978
– reference: 5) Stark DD, Moseley ME, Bacon BR, Moss AA, Goldberg HI, Bass NM, James TL: Magnetic resonance imaging and spectroscopy of hepatic iron overload. Radiology 154: 137-142, 1985
– reference: 10) Moreb J, Popovtzer MM, Friedlaender MM, Konijn AM, Hershko C: Evalvation of iron. Status in patients on chronic hemodialysis: Relative usefulness of bone marrow hemosiderin, serum ferritin, transferrin saturation, mean corpuscular volume and red cell protoporphyrin. Nephron 35: 196-200, 1983
– reference: 8) Mirahmadi KS, Paul WL, Winer RL, Dabirvazir H, Bill Byer, Gorman JJ, Rosen SM: Serum ferritin level. Determination of iron requirement in hemodialysis patient. JAMA 238: 601, 1977
– reference: 13) Chapman RWG, Williams G, Bydder G, Dick R, Sherlock S, Kreel L: Computedtomography for determing liver iron content in primary hemochromatosis. Br Med J 16: 440-442, 1980
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SubjectTerms chronic hemodialysis patient
ferritin
hemosiderosis
MRI
Title The utility of magnetic resonance imaging (MRI) in diagnosing hemosiderosis of long term hemodialysis patients
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