Heart, Liver, and Pancreas MRI Evaluation of Iron Overload

Abstract

Although the human body has a very well-controlled absorption of iron, it has no effective form of excretion. Excess iron can lead to toxicity because this element can catalyze the conversion of hydrogen peroxide into free radicals, causing damage to the cell membranes, proteins, and DNA. There is a great concern about persistent long-term myocardial iron overload which can lead to cardiomyopathy and heart failure. Also, in the liver, it increases the risk of fibrosis, cirrhosis, and hepatoma. The signs and symptoms of iron overload are highly nonspecific, and using clinical criteria, it is impossible to predict, at an early stage, which patients are at high risk of dying from iron-related heart failure. The measurement of plasma ferritin provides an indirect estimate of total body iron stores, but the usefulness of this measurement is limited by many common clinical conditions such as inflammation, fever, and liver disease; also, it does not reflect myocardial iron overload. By the other hand, magnetic resonance imaging is a robust noninvasive method to detect tissue iron overload, allowing early diagnosis and treatment, improving survival.