Liver Magnetic Resonance Elastography: Focus on Methodology, Technique, and Feasibility
Marta Zerunian,
Benedetta Masci,
Damiano Caruso,
Francesco Pucciarelli,
Michela Polici,
Stefano Nardacci,
Domenico De Santis,
Elsa Iannicelli,
Andrea Laghi
Affiliations
Marta Zerunian
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
Benedetta Masci
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
Damiano Caruso
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
Francesco Pucciarelli
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
Michela Polici
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
Stefano Nardacci
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
Domenico De Santis
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
Elsa Iannicelli
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
Andrea Laghi
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
Magnetic resonance elastography (MRE) is an imaging technique that combines low-frequency mechanical vibrations with magnetic resonance imaging to create visual maps and quantify liver parenchyma stiffness. As in recent years, diffuse liver diseases have become highly prevalent worldwide and could lead to a chronic condition with different stages of fibrosis. There is a strong necessity for a non-invasive, highly accurate, and standardised quantitative assessment to evaluate and manage patients with different stages of fibrosis from diagnosis to follow-up, as the actual reference standard for the diagnosis and staging of liver fibrosis is biopsy, an invasive method with possible peri-procedural complications and sampling errors. MRE could quantitatively evaluate liver stiffness, as it is a rapid and repeatable method with high specificity and sensitivity. MRE is based on the propagation of mechanical shear waves through the liver tissue that are directly proportional to the organ’s stiffness, expressed in kilopascals (kPa). To obtain a valid assessment of the real hepatic stiffness values, it is mandatory to obtain a high-quality examination. To understand the pearls and pitfalls of MRE, in this review, we describe our experience after one year of performing MRE from indications and patient preparation to acquisition, quality control, and image analysis.