Cirrhosis MRI
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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]
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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
The role of magnetic resonance imaging (MRI) in the diagnosis of cirrhosis is unclear. Despite much enthusiasm about the potential of MRI in the evaluation of the cirrhotic patient, its use today is limited by expense, patient intolerability, and the ability to obtain information provided by MRI through other means.
Although 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. Some authors report that MRI can accurately diagnose cirrhosis and provide correlation with its severity. [1][2][3] One study found the sensitivity and specificity of an MRI scoring system in distinguishing Child-Pugh grade A cirrhosis from other grades to be 93 and 82 percent, respectively.[1] MRI may also reveal an iron overload and provide an estimate of the hepatic iron concentration.
- Magnetic resonance imaging (MRI):[5][7][11][12]
- determines the nature of focal lesions such as hepatic metastases
- nodular regeneration
- Decreased signal intensity on magnetic resonance imaging may indicate iron overload from hereditary hemochromatosis.
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. [13]
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.
MRI Images
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References
- ↑ 1.0 1.1 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. American Journal of Roentgenology. 173 (3): 591–6. PMID 10470885. Retrieved 2012-09-06. Unknown parameter
|month=ignored (help) - ↑ 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) - ↑ 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) - ↑ 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.
- ↑ 5.0 5.1 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.
- ↑ 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.
- ↑ 7.0 7.1 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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)