Comparative study of magnetic resonance imaging, computed tomography and histology in the assessment of liver iron overload.

Magnetic resonance imaging, computed tomography, and liver biopsy findings were compared in ten patients with serum ferritin levels over 500 ng/ml. The liver was observed as a low-intensity area on magnetic resonance imaging in all four patients with serum ferritin levels above 2,000 ng/ml, while no abnormalities were detected in four of the six patients with a serum ferritin level below 2,000 ng/ml. Computed tomography revealed the liver to be a high density area in five of the seven patients tested. However, it demonstrated no abnormality in a patient with steatosis despite a high serum ferritin concentration. Liver biopsy demonstrated iron deposits in nine of the ten patients. These findings indicate that liver biopsy remains the most accurate mean of detection of liver iron overload. Both magnetic resonance imaging and computed tomography could be used to be monitor the progress of a patient with liver iron overload treated by phlebotomy.