(Circulation. 1998;97:2371.)
© 1998 American Heart Association, Inc.
Images in Cardiovascular Medicine |
Iron Deposition in Myocardium Documented on Standard Computed Tomography in Cardiac Hemochromatosis
Shinichi Niwano, MD;
Junji Yokoyama, MD;
Hiroe Niwano, MD;
; Yoshifusa Aizawa, MD
From the First Department of Internal Medicine, Niigata University School
of Medicine, Niigata, Japan.
Correspondence to Shinichi Niwano, MD, The First Department of Internal Medicine, Niigata University School of Medicine, 1–754 Asahi-machi Niigata, 951, Japan.
A 46-year-old
woman with pure red-cell aplasia suffered blood transfusion of >200
units, ie, >20 g in iron weight, over 4 years because treatment with a
series of immunosuppressants resulted in no effect. Tissue iron
deposition caused by iron overload resulted in skin discoloration,
hepatic injury, diabetes mellitus, and slight left
ventricular dysfunction. Left ventricular
end-diastolic and end-systolic dimensions were 45
and 33 mm, respectively, on echocardiogram, and left
ventricular ejection fraction was 52%. On standard CT, ie,
one scan per 4 seconds, the liver showed a high-density signal before
use of contrast medium as a result of iron deposition (Figure 1
). On the same series of CT scans, the
left ventricular wall could also be identified as a
high-density signal, with neither gated scanning nor cine scanning used
(Figure 2).
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Figure 1. Standard-plane CT scanning of abdomen without
contrast enhancement at level of first lumbar vertebra. Whole liver
clearly appeared as high-density area because of tissue iron
deposition. Bile ducts and hepatic vessels were identified as
low-density area, as observed in normal subjects.
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Figure 2. Standard-plane CT scanning of chest without
contrast enhancement at level of seventh thoracic vertebra. Gated
scanning was not used, and scanning speed was one scan per 4 seconds.
Right ventricle (top), left ventricle (bottom), and left atrium were
scanned at this level. Left ventricular wall and part of
right ventricular wall could be identified as high-density
area as a result of iron deposition in myocardium.
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Footnotes
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.
