Discordance of liver and myocardial iron.

In A the patient has heavy liver iron loading (black liver), but the heart retains signal indicating light loading (arrow). If management or myocardial iron were based on a liver biopsy in this patient, chelation treatment might be increased, but the risk of cardiac complications from iron overload is low. In B the patient has little liver iron loading (grey liver), but the heart has low signal indicating heavy loading (arrow). If management or myocardial iron were based on a liver biopsy in this patient, chelation treatment might be maintained at current levels or even decreased, but the risk of cardiac complications from iron overload is high.