MR Elastography and Functional MRI of the Liver

Abstract

Hepatobiliary Magnetic resonance imaging (MRI) has progressed in the last decade, actually combining morphological and functional data analysis concerning liver parenchyma and focal lesion(s). A correct liver MRI protocol combining morphological and functional sequences allow to detect and characterize liver diffuse pathologies (such as steatosis, hemochromatosis, liver fibrosis, sinusoidal obstructive syndrome, etc.) and/or different type of nodules developed into a normal liver parenchyma or altered liver tissue (e.g. chronic hepatitis, steatofibrosis, liver cirrhosis). Magnetic Resonance Elastography (MRE) is a non-invasive and accurate alternative imaging technique to invasive liver biopsy used in our days to diagnose, quantify and follow-up liver fibrosis. Diffusion weighted imaging (DWI) plays a major role in liver lesions detection, in particular in the detection of metastases in patients with known cancer but also provides information concerning the detection and characterization of liver damage (e.g. liver fibrosis) and for measuring the therapeutic response. MRI evaluation of the liver with specific Gadolinium based contrast agents offer a better detection and characterization of liver lesions having additional advantages to non-specific extracellular MRI contrast agents such as a higher and “specific” enhancement of liver parenchyma correlated with hepatocytes function, and an optimal evaluation of the biliary tree.