Liver MR Elastography Technique and Image Interpretation: Pearls and Pitfalls

Area of Science:

• Medical Imaging
• Hepatology
• Radiology

Background:

• Liver MR elastography measures liver stiffness to evaluate fibrosis and cirrhosis.
• Accurate liver stiffness measurement (LSM) is crucial for staging liver fibrosis.

Purpose of the Study:

• To review the core components of liver MR elastography for accurate and reliable LSM.
• To provide guidance on optimizing imaging technique, quality control, and interpretation for clinical services.

Main Methods:

• Optimization of six technical parameters: patient fasting, driver placement, section positioning, end-expiration sequencing, timing, and pulse sequence parameters.
• Immediate review of elastograms for diagnostic quality and potential repeat scans.
• Understanding proper LSM technique, including measurement areas and confounding factors.

Main Results:

• Detailed review of technical parameter optimization for MR elastography.
• Emphasis on prompt quality control and immediate assessment of elastogram quality.
• Guidance on accurate interpretation and reporting of elastography findings, considering various causes of increased liver stiffness.

Conclusions:

• Mastery of imaging technique, quality control, and interpretation is essential for reliable liver MR elastography.
• This review provides a framework for implementing and operating a clinical liver MR elastography service.
• Properly performed and interpreted MR elastography aids in the evaluation of liver fibrosis and cirrhosis.