GI Radiology > Liver > Diffuse > Hemochromatosis


Diffuse Hepatic Disease

Hemochromatosis

  1. Pathology:
  • Iron overload leads to deposition in the liver. The liver can be enlarged.
     
  • Primary hemochromatosis: an autosomal recessive disease that has abnormal absorption of iron in the intestine and thus causes iron to be deposited in hepatocytes, spleen, pancreas, and the myocardium.
     
  • Secondary hemochromatosis: caused by multiple transfusions with deposition of iron in the reticuloendothelial cells of the liver and the spleen. However, the pancreas is NOT usually involved. If the pancreas is involved, the hemochromatosis is usually of the primary type.
  1. Radiographic findings:
  • U/S: hyperechoic liver (but can look normal).
     
  • CT: hyperdense liver (> 75 HU). There are similar findings in Wilson's disease, amiodarone toxicity, and previous thorotrast exposure.

  • T1- and T2-weighted MRI: Liver and spleen are hyperintense (very dark liver) compared with adjacent muscles owing to paramagnetic effect. Normally, the signal intensity of the liver parenchyma is equal to or slightly greater than that of muscle.

 

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