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

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).

PURPOSE: To determine whether the frequency of hepatocellular carcinoma (HCC) in patients with cirrhosis is affected by hepatic iron deposition as detected with magnetic resonance (MR) imaging.

MATERIALS AND METHODS: In a retrospective search of MR imaging and histopathology records, 196 patients with histopathologically proved cirrhosis and with (n = 80) or without (n = 116) HCC who underwent T2-weighted conventional or fast spin-echo and gradient-echo (GRE) (echo time 6.0 msec) imaging were identified. MR images were qualitatively and quantitatively evaluated for diffuse hepatic iron deposition and siderotic regenerative nodules to assess their correlation with the presence of HCC.

RESULTS: Hepatic parenchymal iron deposition was seen in 79 (40%) patients, and iron deposition in regenerative nodules was seen in 71 (36%) at MR imaging. The mean signal intensity ratio of GRE images in patients with hepatic iron deposition was significantly lower than that in patients without it (P < .001). The frequency of HCC in patients with iron deposition in regenerative nodules (52% [37 of 71 patients]) was significantly higher (P = .015) than that in patients without iron in regenerative nodules (34% [43 of 125 patients]).

CONCLUSION: The occurrence of HCC may be associated causally with iron deposition in regenerative nodules in patients with cirrhosis. MR imaging can enable detection of iron deposition in regenerative nodules as a possible risk factor for the development of HCC.

Index terms: Hepatitis, 761.291 • Liver, cirrhosis, 761.794 • Liver, iron content, 761.659 • Liver, MR, 761.121411, 761.121412, 761.121415, 761.12143 • Liver, nodules, 761.3198 • Liver, regeneration, 761.3198 • Liver neoplasms, diagnosis, 761.121411, 761.121412, 761.121415, 761.12143, 761.323

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