Liver imaging: haemochromatosis on MRI: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Liver imaging: haemochromatosis on MRI

Sample item

A middle-aged man with diabetes, skin pigmentation and raised ferritin has an MRI that shows a markedly low signal liver on in-phase gradient echo images, which drops further with a longer echo time. What does this mean?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Iron overload of the liver from haemochromatosis

Iron is paramagnetic and causes signal loss through susceptibility effects, which grow with longer echo time, so the liver becomes dark on T2 and gradient echo images. Fat instead drops signal on opposed-phase images.

Option by option

  • A. Cystic fibrosis of the liver

    Cystic fibrosis causes biliary changes and fatty or cirrhotic liver, not a dark iron-like liver.

  • B. Acute hepatitis

    Acute hepatitis causes periportal oedema and not a dark liver.

  • C. Iron overload of the liver from haemochromatosis (correct)

    Correct. Signal loss that increases with echo time is the iron signature.

  • D. Fatty infiltration of the liver

    Fat loses signal on opposed phase and not progressively with echo time.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Iron overload of the liver from haemochromatosis. Iron is paramagnetic and causes signal loss through susceptibility effects, which grow with longer echo time, so the liver becomes dark on T2 and gradient echo images.

Why is "Cystic fibrosis of the liver" not the answer?

Cystic fibrosis causes biliary changes and fatty or cirrhotic liver, not a dark iron-like liver.

Why is "Acute hepatitis" not the answer?

Acute hepatitis causes periportal oedema and not a dark liver.

Why is "Fatty infiltration of the liver" not the answer?

Fat loses signal on opposed phase and not progressively with echo time.

What concept does this question test?

It tests Liver imaging: haemochromatosis on MRI in Radiology. Fat instead drops signal on opposed-phase images.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Liver imaging: haemochromatosis on MRI?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.