Magnetic resonance imaging of the liver

A variety of diffuse and focal disease processes affect the liver. MRI is likely the imaging modality of choice for investigation of patients suspected of having diffuse disease such as cirrhosis, hemochromatosis, or fatty infiltration. MRI is extremely effective at detecting and characterizing focal hepatic lesions. In particular, patients suspected of possessing hemangiomas, hepatocellular carcinoma, or hypervascular liver metastases are better evaluated by MRI than other imaging modalities. Immediate post gadolinium spoiled gradient echo and T2-weighted fat suppressed spin echo are very effective at lesion detection, whereas serial post gadolinium spoiled gradient echo is essential for lesion characterization. New fast T2-weighted sequences and tissue specific contrast agents may further increase the role of liver MRI by shortening exam time and increasing sensitivity and specificity, respectively.