Investig Magn Reson Imaging.  2019 Dec;23(4):390-394. 10.13104/imri.2019.23.4.390.

Transfusional Iron Overload and Choroid Plexus Hemosiderosis in a Pediatric Patient: Brain Magnetic Resonance Imaging Findings

• Kim MS
• Lee HY
• Lim MK
• Kang YH
• Kim JH
• Lee KH

• KMID: 2468058
• DOI: http://doi.org/10.13104/imri.2019.23.4.390

Abstract

Hemosiderosis is characterized by the deposition of excess iron in body tissues. The choroid plexus is an important part of the central nervous system that can be the primary site of iron overload. T2*-weighted gradient echo (GRE) sequence provides high sensitivity for demonstrating cerebral microhemorrhagic foci and iron deposition. In the present study, we describe the case of a 15-year-old boy with acute lymphoblastic leukemia, in whom repeated transfusion led to iron accumulation in the brain. GRE sequence effectively demonstrated hemosiderin deposition in the choroid plexus.

Keyword

Hemosiderosis; Choroid plexus; Gradient echo sequence; Brain magnetic resonance imaging

MeSH Terms

Adolescent
Brain*
Central Nervous System
Choroid Plexus*
Choroid*
Hemosiderin
Hemosiderosis*
Humans
Iron Overload*
Iron*
Magnetic Resonance Imaging*
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Hemosiderin
Iron

Figure

• 

  Fig. 1 MR images of choroid plexus hemosiderosis in a 15-year-old male with acute lymphoblastic leukemia in whom repeated blood transfusions led to iron overload. (a-e) Axial T2*-weighted gradient echo images demonstrate the presence of hypointense hemosiderin deposits in the choroid plexus of both the lateral ventricles (black arrows), both the foramina of Monro (open arrow), 3rd ventricle (white arrow), 4th ventricle (arrowhead), and both the foramina of Luschka (asterisks).

• 

  Fig. 2 T1-weighted image (WI) (a), axial (b) and coronal (c) T2WI, and fluid-attenuated inversion recovery (d) and postcontrast T1WI (e) show no remarkable abnormality in the ventricular system (arrows).

• 

  Fig. 3 CT images of choroid plexus. (a, b) No calcification or hemorrhage is observed in the choroid plexus (arrows) on precontrast CT images.

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