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Introduction
Splenic siderotic nodules, also known as Gamna-Gandy bodies (GGBs), are small granuloma-like nodules that most frequently occur within the spleen. GGBs were first observed in a patient with biliary cirrhosis and were described by the French physician, Charles Gandy (1872–1943), in 1905. The nature of the GGBs was further investigated in 1921 by the Italian pathologist, Carlo Gamna (1866–1950). GGBs have been revealed to measure a few millimeters in size and be composed of hemosiderin, calcium and fibrous tissue, with a crystal structure of CaPO4.FeOH. The iron inclusions favor the deposition of calcium salts (1,2).
There have been relatively few studies concerning the imaging of siderotic nodules in the spleen, although due to the hemosiderin inclusion within the nodules, it has been suggested that gradient-echo (GRE) magnetic resonance imaging (MRI) sequence may be more sensitive to this type of nodule than alternative imaging modalities (3–7). In the past decade, a novel MRI sequence, enhanced-susceptibility weighted angiography (ESWAN), has been widely used in clinical practice (8,9). Due to its sensitivity to the susceptibility differences between substances, such as deoxyhemoglobin, iron and calcium, this new sequence is able to enhance the susceptibility contrast between tissues and highlight lesions, such as hemorrhages and hemosiderin. The sequence has been predominantly utilized for brain imaging, although other applications have also been described (10–15). In 2011, a new 3.0 T MRI scanner was installed in the Department of Radiology, Renmin Hospital of Wuhan University (Wuhan, China) and the ESWAN sequence was utilized for the detection and assessment of liver siderotic nodules and iron deposition in patients with liver cirrhosis, in addition to being used for brain imaging. Following the observation of abnormal signals (siderotic nodules) in the spleen, a number of patients were retrospectively reviewed, the MRI appearances, liver function and blood cell counts were studied and the correlation between splenic siderotic nodules and hypersplenism was discussed. Furthermore, the interrelation between liver function, thrombocytopenia and splenomegaly and the formation of splenic siderotic nodules in patients with liver cirrhosis was evaluated. To the best of our knowledge, there have been no previous investigations into the interrelations between splenic siderotic nodules and the clinical data from patients with liver cirrhosis or into the application of the ESWAN sequence for splenic...