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==Overview==
==Overview==
The use of magnetic resonance imaging (MRI) as a diagnostic test for cirrhosis is uncertain. MRI sometimes differentiates among regenerating or dysplastic nodules and [[hepatocellular carcinoma]], it is best used as a follow-up study to determine whether lesions have changed in appearance and size.
The use of magnetic resonance imaging (MRI) as a diagnostic test for cirrhosis is uncertain. MRI sometimes differentiates among [[Regeneration|regenerating]] or [[Dysplasia|dysplastic]] [[Nodule (medicine)|nodules]] and [[hepatocellular carcinoma]], it is best used as a follow-up study to determine whether [[Lesion|lesions]] have changed in appearance and size.


==MRI==
==MRI==
*
Role of MRI in cirrhosis:<ref name="pmid10405746">{{cite journal |vauthors=Bonkovsky HL, Rubin RB, Cable EE, Davidoff A, Rijcken TH, Stark DD |title=Hepatic iron concentration: noninvasive estimation by means of MR imaging techniques |journal=Radiology |volume=212 |issue=1 |pages=227–34 |year=1999 |pmid=10405746 |doi=10.1148/radiology.212.1.r99jl35227 |url=}}</ref><ref name="pmid104708852">{{cite journal |vauthors=Ito K, Mitchell DG, Hann HW, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N |title=Viral-induced cirrhosis: grading of severity using MR imaging |journal=AJR Am J Roentgenol |volume=173 |issue=3 |pages=591–6 |year=1999 |pmid=10470885 |doi=10.2214/ajr.173.3.10470885 |url=}}</ref><ref name="pmid9129412">{{cite journal |vauthors=Ernst O, Sergent G, Bonvarlet P, Canva-Delcambre V, Paris JC, L'Herminé C |title=Hepatic iron overload: diagnosis and quantification with MR imaging |journal=AJR Am J Roentgenol |volume=168 |issue=5 |pages=1205–8 |year=1997 |pmid=9129412 |doi=10.2214/ajr.168.5.9129412 |url=}}</ref><ref name="pmid7972774">{{cite journal |vauthors=Gandon Y, Guyader D, Heautot JF, Reda MI, Yaouanq J, Buhé T, Brissot P, Carsin M, Deugnier Y |title=Hemochromatosis: diagnosis and quantification of liver iron with gradient-echo MR imaging |journal=Radiology |volume=193 |issue=2 |pages=533–8 |year=1994 |pmid=7972774 |doi=10.1148/radiology.193.2.7972774 |url=}}</ref><ref name="pmid103525972">{{cite journal |vauthors=Ito K, Mitchell DG, Gabata T, Hussain SM |title=Expanded gallbladder fossa: simple MR imaging sign of cirrhosis |journal=Radiology |volume=211 |issue=3 |pages=723–6 |year=1999 |pmid=10352597 |doi=10.1148/radiology.211.3.r99ma31723 |url=}}</ref><ref name="pmid96098972">{{cite journal |vauthors=Ito K, Mitchell DG, Hann HW, Outwater EK, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N |title=Progressive viral-induced cirrhosis: serial MR imaging findings and clinical correlation |journal=Radiology |volume=207 |issue=3 |pages=729–35 |year=1998 |pmid=9609897 |doi=10.1148/radiology.207.3.9609897 |url=}}</ref><ref name="pmid82736432">{{cite journal |vauthors=Finn JP, Kane RA, Edelman RR, Jenkins RL, Lewis WD, Muller M, Longmaid HE |title=Imaging of the portal venous system in patients with cirrhosis: MR angiography vs duplex Doppler sonography |journal=AJR Am J Roentgenol |volume=161 |issue=5 |pages=989–94 |year=1993 |pmid=8273643 |doi=10.2214/ajr.161.5.8273643 |url=}}</ref>
* The role of magnetic resonance imaging (MRI) in the diagnosis of cirrhosis is unclear.  
* The role of magnetic resonance imaging (MRI) in the diagnosis of cirrhosis is unclear.  
* The use of MRI is limited by expense, patient intolerability, and the ability to obtain information provided by MRI through other means.  
* The use of MRI is limited by expense, patient intolerability, and the ability to obtain information provided by MRI through other means.  
* MRI differentiates among regenerating or dysplastic [[Nodule (medicine)|nodules]] and [[hepatocellular carcinoma]] by accurately determining the nature of focal lesions.<ref name="pmid10405746" /><ref name="pmid104708852" /><ref name="pmid11584240">{{cite journal |vauthors=Choi D, Kim SH, Lim JH, Cho JM, Lee WJ, Lee SJ, Lim HK |title=Detection of hepatocellular carcinoma: combined T2-weighted and dynamic gadolinium-enhanced MRI versus combined CT during arterial portography and CT hepatic arteriography |journal=J Comput Assist Tomogr |volume=25 |issue=5 |pages=777–85 |year=2001 |pmid=11584240 |doi= |url=}}</ref><ref name="pmid16244259">{{cite journal |vauthors=Qayyum A, Goh JS, Kakar S, Yeh BM, Merriman RB, Coakley FV |title=Accuracy of liver fat quantification at MR imaging: comparison of out-of-phase gradient-echo and fat-saturated fast spin-echo techniques--initial experience |journal=Radiology |volume=237 |issue=2 |pages=507–11 |year=2005 |pmid=16244259 |doi=10.1148/radiol.2372040539 |url=}}</ref>  
* MRI differentiates among [[Regeneration|regenerating]] or [[Dysplasia|dysplastic]] [[Nodule (medicine)|nodules]] and [[hepatocellular carcinoma]] by accurately determining the nature of focal lesions.<ref name="pmid10405746" /><ref name="pmid104708852" /><ref name="pmid11584240">{{cite journal |vauthors=Choi D, Kim SH, Lim JH, Cho JM, Lee WJ, Lee SJ, Lim HK |title=Detection of hepatocellular carcinoma: combined T2-weighted and dynamic gadolinium-enhanced MRI versus combined CT during arterial portography and CT hepatic arteriography |journal=J Comput Assist Tomogr |volume=25 |issue=5 |pages=777–85 |year=2001 |pmid=11584240 |doi= |url=}}</ref><ref name="pmid16244259">{{cite journal |vauthors=Qayyum A, Goh JS, Kakar S, Yeh BM, Merriman RB, Coakley FV |title=Accuracy of liver fat quantification at MR imaging: comparison of out-of-phase gradient-echo and fat-saturated fast spin-echo techniques--initial experience |journal=Radiology |volume=237 |issue=2 |pages=507–11 |year=2005 |pmid=16244259 |doi=10.1148/radiol.2372040539 |url=}}</ref>  
* MRI is used as a follow-up study to determine whether lesions have changed in appearance and size.  
* MRI is used as a follow-up study to determine whether lesions have changed in appearance and size.  
* MRI may accurately diagnose cirrhosis and determines disease severity.<ref name="pmid10470885">{{cite journal |author=Ito K, Mitchell DG, Hann HW, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N |title=Viral-induced cirrhosis: grading of severity using MR imaging |journal=[[AJR. American Journal of Roentgenology]] |volume=173 |issue=3 |pages=591–6 |year=1999 |month=September |pmid=10470885 |doi= |url=http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=10470885 |accessdate=2012-09-06}}</ref><ref name="pmid10352597">{{cite journal |author=Ito K, Mitchell DG, Gabata T, Hussain SM |title=Expanded gallbladder fossa: simple MR imaging sign of cirrhosis |journal=[[Radiology]] |volume=211 |issue=3 |pages=723–6 |year=1999 |month=June |pmid=10352597 |doi= |url=http://radiology.rsnajnls.org/cgi/pmidlookup?view=long&pmid=10352597 |accessdate=2012-09-06}}</ref><ref name="pmid9609897">{{cite journal |author=Ito K, Mitchell DG, Hann HW, Outwater EK, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N |title=Progressive viral-induced cirrhosis: serial MR imaging findings and clinical correlation |journal=[[Radiology]] |volume=207 |issue=3 |pages=729–35 |year=1998 |month=June |pmid=9609897 |doi= |url=http://radiology.rsnajnls.org/cgi/pmidlookup?view=long&pmid=9609897 |accessdate=2012-09-06}}</ref>  
* MRI may accurately diagnose cirrhosis and determines disease severity.<ref name="pmid10470885">{{cite journal |author=Ito K, Mitchell DG, Hann HW, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N |title=Viral-induced cirrhosis: grading of severity using MR imaging |journal=[[AJR. American Journal of Roentgenology]] |volume=173 |issue=3 |pages=591–6 |year=1999 |month=September |pmid=10470885 |doi= |url=http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=10470885 |accessdate=2012-09-06}}</ref><ref name="pmid10352597">{{cite journal |author=Ito K, Mitchell DG, Gabata T, Hussain SM |title=Expanded gallbladder fossa: simple MR imaging sign of cirrhosis |journal=[[Radiology]] |volume=211 |issue=3 |pages=723–6 |year=1999 |month=June |pmid=10352597 |doi= |url=http://radiology.rsnajnls.org/cgi/pmidlookup?view=long&pmid=10352597 |accessdate=2012-09-06}}</ref><ref name="pmid9609897">{{cite journal |author=Ito K, Mitchell DG, Hann HW, Outwater EK, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N |title=Progressive viral-induced cirrhosis: serial MR imaging findings and clinical correlation |journal=[[Radiology]] |volume=207 |issue=3 |pages=729–35 |year=1998 |month=June |pmid=9609897 |doi= |url=http://radiology.rsnajnls.org/cgi/pmidlookup?view=long&pmid=9609897 |accessdate=2012-09-06}}</ref>  
* Decreased signal intensity on MRI may also reveal an iron overload and provides an estimate of the hepatic iron concentration.
* Decreased signal intensity on MRI may also reveal an [[iron]] overload and provides an estimate of the [[Liver|hepatic]] [[iron]] concentration.
'''MRI'''<ref name="pmid10405746">{{cite journal |vauthors=Bonkovsky HL, Rubin RB, Cable EE, Davidoff A, Rijcken TH, Stark DD |title=Hepatic iron concentration: noninvasive estimation by means of MR imaging techniques |journal=Radiology |volume=212 |issue=1 |pages=227–34 |year=1999 |pmid=10405746 |doi=10.1148/radiology.212.1.r99jl35227 |url=}}</ref><ref name="pmid104708852">{{cite journal |vauthors=Ito K, Mitchell DG, Hann HW, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N |title=Viral-induced cirrhosis: grading of severity using MR imaging |journal=AJR Am J Roentgenol |volume=173 |issue=3 |pages=591–6 |year=1999 |pmid=10470885 |doi=10.2214/ajr.173.3.10470885 |url=}}</ref><ref name="pmid9129412">{{cite journal |vauthors=Ernst O, Sergent G, Bonvarlet P, Canva-Delcambre V, Paris JC, L'Herminé C |title=Hepatic iron overload: diagnosis and quantification with MR imaging |journal=AJR Am J Roentgenol |volume=168 |issue=5 |pages=1205–8 |year=1997 |pmid=9129412 |doi=10.2214/ajr.168.5.9129412 |url=}}</ref><ref name="pmid7972774">{{cite journal |vauthors=Gandon Y, Guyader D, Heautot JF, Reda MI, Yaouanq J, Buhé T, Brissot P, Carsin M, Deugnier Y |title=Hemochromatosis: diagnosis and quantification of liver iron with gradient-echo MR imaging |journal=Radiology |volume=193 |issue=2 |pages=533–8 |year=1994 |pmid=7972774 |doi=10.1148/radiology.193.2.7972774 |url=}}</ref><ref name="pmid103525972">{{cite journal |vauthors=Ito K, Mitchell DG, Gabata T, Hussain SM |title=Expanded gallbladder fossa: simple MR imaging sign of cirrhosis |journal=Radiology |volume=211 |issue=3 |pages=723–6 |year=1999 |pmid=10352597 |doi=10.1148/radiology.211.3.r99ma31723 |url=}}</ref><ref name="pmid96098972">{{cite journal |vauthors=Ito K, Mitchell DG, Hann HW, Outwater EK, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N |title=Progressive viral-induced cirrhosis: serial MR imaging findings and clinical correlation |journal=Radiology |volume=207 |issue=3 |pages=729–35 |year=1998 |pmid=9609897 |doi=10.1148/radiology.207.3.9609897 |url=}}</ref><ref name="pmid82736432">{{cite journal |vauthors=Finn JP, Kane RA, Edelman RR, Jenkins RL, Lewis WD, Muller M, Longmaid HE |title=Imaging of the portal venous system in patients with cirrhosis: MR angiography vs duplex Doppler sonography |journal=AJR Am J Roentgenol |volume=161 |issue=5 |pages=989–94 |year=1993 |pmid=8273643 |doi=10.2214/ajr.161.5.8273643 |url=}}</ref>
==MRA==
==MRA==
Although used rarely, magnetic resonance angiography (MRA) can assess portal hypertensive changes including flow volume and direction, as well as portal vein thrombosis. MR angiography is more sensitive than [[ultrasonography]] in diagnosing complications of cirrhosis such as [[portal vein]] [[thrombosis]]. <ref name="pmid8273643">{{cite journal |author=Finn JP, Kane RA, Edelman RR, Jenkins RL, Lewis WD, Muller M, Longmaid HE |title=Imaging of the portal venous system in patients with cirrhosis: MR angiography vs duplex Doppler sonography |journal=[[AJR. American Journal of Roentgenology]] |volume=161 |issue=5 |pages=989–94 |year=1993 |month=November |pmid=8273643 |doi= |url=http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=8273643 |accessdate=2012-09-06}}</ref>
* [[Magnetic resonance angiography]] ([[Magnetic resonance angiography|MRA]]) may be used to assess [[Portal hypertension|portal hypertensive]] changes including volume and direction of blood flow in the [[portal vein]].  
* [[Magnetic resonance angiography|MR angiography]] is more sensitive than [[ultrasonography]] in diagnosing complications of cirrhosis such as [[portal vein]] [[thrombosis]].<ref name="pmid8273643">{{cite journal |author=Finn JP, Kane RA, Edelman RR, Jenkins RL, Lewis WD, Muller M, Longmaid HE |title=Imaging of the portal venous system in patients with cirrhosis: MR angiography vs duplex Doppler sonography |journal=[[AJR. American Journal of Roentgenology]] |volume=161 |issue=5 |pages=989–94 |year=1993 |month=November |pmid=8273643 |doi= |url=http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=8273643 |accessdate=2012-09-06}}</ref>


Despite the potential of MRI and MRA in the diagnosis and evaluation of patients with cirrhosis, their widespread use is limited by their expense and by the ability of routine ultrasonography with Doppler to obtain adequate information for the diagnosis of cirrhosis and presence of complications.
* The use of [[Magnetic resonance angiography|MRA]] is limited by its expense and the ability of routine [[Medical ultrasonography|ultrasonography]] with Doppler to obtain adequate information for the diagnosis of cirrhosis and presence of complications.
*Magnetic resonance angiography (MRA) is more sensitive than ultrasonography for diagnosing complications of cirrhosis:
* portal vein thrombosis 
*CT portal phase imaging, MRA can determine the volume and direction of blood flow in the portal vein. 
 
===MRI Images===
<gallery>
<gallery>
Image:Cirrhosis-001.jpg|T2
Image:Cirrhosis-001.jpg|T2

Revision as of 18:44, 13 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]

Overview

The use of magnetic resonance imaging (MRI) as a diagnostic test for cirrhosis is uncertain. MRI sometimes differentiates among regenerating or dysplastic nodules and hepatocellular carcinoma, it is best used as a follow-up study to determine whether lesions have changed in appearance and size.

MRI

Role of MRI in cirrhosis:[1][2][3][4][5][6][7]

  • The role of magnetic resonance imaging (MRI) in the diagnosis of cirrhosis is unclear.
  • The use of MRI is limited by expense, patient intolerability, and the ability to obtain information provided by MRI through other means.
  • MRI differentiates among regenerating or dysplastic nodules and hepatocellular carcinoma by accurately determining the nature of focal lesions.[1][2][8][9]
  • MRI is used as a follow-up study to determine whether lesions have changed in appearance and size.
  • MRI may accurately diagnose cirrhosis and determines disease severity.[10][11][12]
  • Decreased signal intensity on MRI may also reveal an iron overload and provides an estimate of the hepatic iron concentration.

MRA

  • The use of MRA is limited by its expense and the ability of routine ultrasonography with Doppler to obtain adequate information for the diagnosis of cirrhosis and presence of complications.
  • T2
    T2
  • T2
    T2

References

  1. ↑ 1.0 1.1 Bonkovsky HL, Rubin RB, Cable EE, Davidoff A, Rijcken TH, Stark DD (1999). "Hepatic iron concentration: noninvasive estimation by means of MR imaging techniques". Radiology. 212 (1): 227–34. doi:10.1148/radiology.212.1.r99jl35227. PMID 10405746.
  2. ↑ 2.0 2.1 Ito K, Mitchell DG, Hann HW, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N (1999). "Viral-induced cirrhosis: grading of severity using MR imaging". AJR Am J Roentgenol. 173 (3): 591–6. doi:10.2214/ajr.173.3.10470885. PMID 10470885.
  3. ↑ Ernst O, Sergent G, Bonvarlet P, Canva-Delcambre V, Paris JC, L'Herminé C (1997). "Hepatic iron overload: diagnosis and quantification with MR imaging". AJR Am J Roentgenol. 168 (5): 1205–8. doi:10.2214/ajr.168.5.9129412. PMID 9129412.
  4. ↑ Gandon Y, Guyader D, Heautot JF, Reda MI, Yaouanq J, Buhé T, Brissot P, Carsin M, Deugnier Y (1994). "Hemochromatosis: diagnosis and quantification of liver iron with gradient-echo MR imaging". Radiology. 193 (2): 533–8. doi:10.1148/radiology.193.2.7972774. PMID 7972774.
  5. ↑ Ito K, Mitchell DG, Gabata T, Hussain SM (1999). "Expanded gallbladder fossa: simple MR imaging sign of cirrhosis". Radiology. 211 (3): 723–6. doi:10.1148/radiology.211.3.r99ma31723. PMID 10352597.
  6. ↑ Ito K, Mitchell DG, Hann HW, Outwater EK, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N (1998). "Progressive viral-induced cirrhosis: serial MR imaging findings and clinical correlation". Radiology. 207 (3): 729–35. doi:10.1148/radiology.207.3.9609897. PMID 9609897.
  7. ↑ Finn JP, Kane RA, Edelman RR, Jenkins RL, Lewis WD, Muller M, Longmaid HE (1993). "Imaging of the portal venous system in patients with cirrhosis: MR angiography vs duplex Doppler sonography". AJR Am J Roentgenol. 161 (5): 989–94. doi:10.2214/ajr.161.5.8273643. PMID 8273643.
  8. ↑ Choi D, Kim SH, Lim JH, Cho JM, Lee WJ, Lee SJ, Lim HK (2001). "Detection of hepatocellular carcinoma: combined T2-weighted and dynamic gadolinium-enhanced MRI versus combined CT during arterial portography and CT hepatic arteriography". J Comput Assist Tomogr. 25 (5): 777–85. PMID 11584240.
  9. ↑ Qayyum A, Goh JS, Kakar S, Yeh BM, Merriman RB, Coakley FV (2005). "Accuracy of liver fat quantification at MR imaging: comparison of out-of-phase gradient-echo and fat-saturated fast spin-echo techniques--initial experience". Radiology. 237 (2): 507–11. doi:10.1148/radiol.2372040539. PMID 16244259.
  10. ↑ Ito K, Mitchell DG, Hann HW, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N (1999). "Viral-induced cirrhosis: grading of severity using MR imaging". AJR. American Journal of Roentgenology. 173 (3): 591–6. PMID 10470885. Retrieved 2012-09-06. Unknown parameter |month= ignored (help)
  11. ↑ Ito K, Mitchell DG, Gabata T, Hussain SM (1999). "Expanded gallbladder fossa: simple MR imaging sign of cirrhosis". Radiology. 211 (3): 723–6. PMID 10352597. Retrieved 2012-09-06. Unknown parameter |month= ignored (help)
  12. ↑ Ito K, Mitchell DG, Hann HW, Outwater EK, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N (1998). "Progressive viral-induced cirrhosis: serial MR imaging findings and clinical correlation". Radiology. 207 (3): 729–35. PMID 9609897. Retrieved 2012-09-06. Unknown parameter |month= ignored (help)
  13. ↑ Finn JP, Kane RA, Edelman RR, Jenkins RL, Lewis WD, Muller M, Longmaid HE (1993). "Imaging of the portal venous system in patients with cirrhosis: MR angiography vs duplex Doppler sonography". AJR. American Journal of Roentgenology. 161 (5): 989–94. PMID 8273643. Retrieved 2012-09-06. Unknown parameter |month= ignored (help)

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