title: Improved siderotic nodule detection in cirrhosis with susceptibility-weighted magnetic resonance imaging: a prospective study.
abstract: BACKGROUND
  Hepatic cirrhosis is a common pathway of progressive liver destruction from multiple causes. Iron uptake can occur within the hepatic parenchyma or within the various nodules that form in a cirrhotic liver, termed siderotic nodules. Siderotic nodule formation has been shown to correlate with inflammatory activity, and while the relationship between siderotic nodule formation and malignancy remains unclear, iron distribution within hepatic nodules has known implications for the detection of hepatocellular carcinoma. We aimed to evaluate the role of abdominal susceptibility-weighted imaging in the detection of siderotic nodules in cirrhotic patients.
  
  
  RESULTS
  Forty-six (46) cirrhotic patients with at least one siderotic nodule detected on previous imaging underwent both computed tomography and magnetic resonance imaging (T1-, T2-, T2*-, and susceptibility-weighted imaging) at 3.0 Tesla. Imaging data was independently analyzed by two radiologists. Siderotic nodule count was determined for each modality and imaging sequence. For each magnetic resonance imaging technique, siderotic nodule conspicuity was assessed on a 3 point scale (1 = weak, 2 = moderate, 3 = strong). More nodules were detected by susceptibility weighted imaging (n = 2935) than any other technique, and significantly more than by T2* weighted imaging (n = 1696, p<0.0001). Lesion conspicuity was also highest with susceptibility-weighted imaging, with all nodules found to be moderate (n = 6) or strong (n = 40); a statistically significant difference (p<0.001).
  
  
  CONCLUSIONS
  Susceptibility-weighted imaging had the greatest lesion conspicuity and detected the highest number of siderotic nodules suggesting it is the most sensitive imaging technique to detect siderotic nodules in cirrhotic patients.
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Zachary
authors.initials: Z
authors.lastname: DelProposto
authors.forename: Dongmei
authors.initials: D
authors.lastname: Wu
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Quan
authors.initials: Q
authors.lastname: Jiang
authors.forename: Stephanie
authors.initials: S
authors.lastname: Xuan
authors.forename: YongQuan
authors.initials: Y
authors.lastname: Ye
authors.forename: Zishu
authors.initials: Z
authors.lastname: Zhang
authors.forename: Jiani
authors.initials: J
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography