title: Detection of siderotic nodules in the liver with susceptibility weighted imaging: correlations to serum ferritin, Child-Pugh grade and hyaluronic acid levels.
abstract: BACKGROUND
  Chronic liver disease causes aberrant formation of fibrous tissue that impedes normal liver function, ultimately resulting in liver cirrhosis. Iron uptake can occur within the hepatic parenchyma or within the various nodules that form in a cirrhotic liver, termed siderotic nodules (SN). We aimed to investigate the diagnostic performance of susceptibility weighted imaging (SWI) for detection of SN in patients with liver cirrhosis, and to evaluate the potential of SN numbers for assessing the degree of hepatic iron deposition, liver function, and liver fibrosis stage.
  
  
  METHODS
  Ninety-one patients with chronic liver cirrhosis, who underwent megnetic resonance imagine (MRI) scanning in our department between November 2010 and April 2011, were included in the study. A 3.0T MRI scanner was used to acquire T1WI, T2WI, T2WI, and SWI images. The number of nodules, signal intensity ratio (SIR), and contrast noise ratio (CNR) were recorded and analyzed by chi-square and ANOVA statistical tests. Correlation analysis was performed to evaluate the correlations between the number of SN and Child-Pugh classification, ferritin and hyaluronic acid levels.
  
  
  RESULTS
  The sensitivity of SWI, T1WI, T2WI, and T2 WI for detecting SN was 62.5%, 12.1%, 24.2% and 41.8%, respectively. SWI detected significantly more nodules than routine T1WI, T2WI, and T2 WI procedures (P < 0.05). The SIR was the lowest in SWI (0.361 ± 0.209), as compared to T1WI (0.852 ± 0.163), T2WI (0.584 ± 0.172), and T2 WI (0.497 ± 0.196). The CNR was the highest in SWI (13.932 ± 5.637), as compared to T1WI (9.147 ± 5.785), T2WI (9.771 ± 5.490), and T2 WI (11.491 ± 4.573). The correlation coefficients of the number of SN with ferritin, Child-Pugh classification, and hyaluronic acid levels were 0.672, -0.055, and 0.163, respectively.
  
  
  CONCLUSIONS
  The sensitivity and contrast of SWI for detecting SN in patients with liver cirrhosis are higher than conventional MRI. The number of SN can help to assess the degree of iron deposition in patients with liver cirrhosis.
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Ran
authors.initials: R
authors.lastname: Tao
authors.forename: Zhong-Lan
authors.initials: ZL
authors.lastname: You
authors.forename: Jiu-Quan
authors.initials: JQ
authors.lastname: Zhang
authors.forename: Yong-Ming
authors.initials: YM
authors.lastname: Dai
authors.forename: Dai-Quan
authors.initials: DQ
authors.lastname: Zhou
authors.forename: Ping
authors.initials: P
authors.lastname: Cai
authors.forename: Yi
authors.initials: Y
authors.lastname: Fan
authors.forename: Jin-Guo
authors.initials: JG
authors.lastname: Cui
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
chemical_list: D006820:Hyaluronic Acid; D005293:Ferritins