Type:
Educational Exhibit
Keywords:
Imaging sequences, MR-Elastography, MR, Liver, Gastrointestinal tract, Abdomen, Tissue characterisation
Authors:
J. Miranda, R. O. F. Bezerra, R. L. D. Azambuja, C. V. D. Oliveira, G. R. Camerin, N. Horvat, G. G. Cerri; São Paulo/BR
DOI:
10.26044/ecr2019/C-2639
Background
Chronic liver diseases ,
regardless their etiologies, culminate in a final common pathway of progressive fibrosis and, eventually,
cirrhosis (Fig.2).[1] There are several causes of chronic liver disease including viral infection,
alcohol abuse,
nonalcoholic fatty liver disease,
biliary disease,
autoimmune disease,
genetic causes,
and metabolic disorders.
Fat,
iron and fibrosis are hallmarks of chronic liver disease and very commonly they coexist in the same patient (Fig.
3).
Iron overload is associated with disease severity and development of fibrosis in patients with fatty liver disease; and fat,
is an important cofactor in the development of fibrosis and cirrhosis in patients with iron overload.[2]
Non-targeted percutaneous liver biopsy and direct histologic characterization are the currently accepted reference standards for the diagnosis of diffuse liver disease; however,
liver biopsy is prone to substantial limitations,
including sampling error (Fig.
4).(1)
Furthermore,
the coexistence of several pathological changes in a chronic liver may act as a confounder to iron and fat quantification. In this context,
multiparametric magnetic resonance imaging (MRI) is growing in use and relevance in the evaluation of chronic liver diseases.(3)