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(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).

View larger version (84K): [in this window] [in a new window]   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.

View larger version (75K): [in this window] [in a new window]   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.

Footnotes

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