Cirrhosis and lesion characterization at MR imaging

Magnetic resonance (MR) imaging has emerged as an important imaging modality for the assessment of cirrhosis and its complications. Faster sequences now allow high-quality liver imaging with high intrinsic soft-tissue contrast. Automated contrast detection methods in combination with faster sequences allow reproducible capture of the arterial phase, which is essential for the detection and characterization of hepatocellular carcinoma. The lack of ionizing radiation permits routine use of gadolinium-enhanced three-dimensional (3D) fat-sup-pressed multiphasic imaging with high temporal and spatial resolution. In addition, MR imaging allows simultaneous evaluation of the background liver parenchyma and the liver lesions with the combined use of sequences that include T2-weighted sequences, T1-weighted sequences (including chemical shift imaging), echoplanar diffusionweighted sequences, dynamic gadolinium-enhanced 3D multiphasic imaging, and liver-specific delayed phase sequences (if contrast agents with hepatobiliary excretion are used). The combination of findings from different sequences often helps pinpoint the nature of the liver abnormalities.