MR imaging in liver cirrhosis: classical and new approaches

OBJECTIVE: The typical histological features of chronic hepatitis and cirrhosis are variable degrees of hepatocellular necrosis and inflammation (activity or grade of disease), fibrosis (stage of disease), and associated fat and iron deposition. These features influence the liver's appearance and must be assessed separately by imaging biomarkers in order to be clinically useful. Hepatic morphologic alterations and features of portal hypertension identify most cases of established cirrhosis. Nowadays, research is focused on developing ways to improve detection of early and intermediate stages of fibrosis as well as hepatocyte dysfunction. Even more, most imaging-related measurements are subject to complex interactions and are influenced by different pathologic processes, such as fatty infiltration, edema, necrosis and iron accumulation. METHODS AND RESULTS: MR experience throughout the last 15 years at the Dr Peset University Hospital is reviewed. CONCLUSION: Nowadays, several biomarkers have been developed to grade the liver status in cirrhosis. This review will focus on these topics.