Quantification of Iron Load using MRI in chronic liver disease patients and correlation with non-chronic liver disease patients

Background: Chronic liver disease (CLD) is frequently associated with disturbances in iron metabolism and hepatic iron deposition, which may not be accurately reflected by serum biomarkers alone. Magnetic Resonance Imaging (MRI) offers a non-invasive and sensitive method for quantifying liver iron concentration. Objectives: To evaluate and compare iron metabolism parameters and hepatic iron deposition using MRI-based assessment in patients with chronic liver disease versus healthy controls. Materials and Methods: This cross-sectional comparative study included 35 patients diagnosed with CLD and 35 age- and gender-matched healthy controls. Clinical evaluation, biochemical parameters including serum ferritin, TIBC, UIBC, serum iron, transferrin saturation, liver enzymes, and albumin were analyzed. MRI was performed to assess liver iron concentration using R² mapping, visual impression grading, and structured MRI grading. Statistical comparisons between groups were done using independent samples t-test and Chi-square test, with p < 0.05 considered statistically significant. Results: CLD patients exhibited significantly lower serum ferritin (149.35 ± 286.86 ng/mL vs. 213.48 ± 373.13 ng/mL; p = 0.001) and R² values (57.82 ± 29.2 vs. 76.43 ± 47.79; p = 0.012), suggesting higher hepatic iron overload. UIBC was significantly elevated in CLD (p = 0.043), while serum iron and transferrin saturation showed no significant difference. Liver enzymes (SGOT, SGPT) were significantly higher in the CLD group, and serum albumin was lower, though not statistically significant. MRI grading showed a significantly higher proportion of abnormal iron load in CLD (p = 0.0045), and light iron overload was more frequently observed in MRI impressions among CLD patients. Conclusion: Patients with chronic liver disease demonstrate significant disruptions in iron metabolism and increased hepatic iron deposition as detected by MRI. Quantitative MRI, particularly R² mapping and structured grading, is a valuable tool for non-invasive assessment of liver iron overload and may be superior to serum markers in detecting early or subclinical hepatic siderosis.