Skip to main content

Advertisement

SpringerLink
Log in

Magnetic resonance elastography of the liver: everything you need to know to get started

  • Review
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Magnetic resonance elastography (MRE) of the liver has emerged as the non-invasive standard for the evaluation of liver fibrosis in chronic liver diseases (CLDs). The utility of MRE in the evaluation of different CLD in both adults and children has been demonstrated in several studies, and MRE has been recommended by several clinical societies. Consequently, the clinical indications for evaluation of CLD with MRE have increased, and MRE is currently used as an add-on test during routine liver MRI studies or as a standalone test. To meet the increasing clinical demand, MRE is being installed in many academic and private practice imaging centers. There is a need for a comprehensive practical guide to help these practices to deliver high-quality liver MRE studies as well as troubleshoot the common issues with MRE to ensure smooth running of the service. This comprehensive clinical practice review summarizes the indications and provides an overview on why to use MRE, technical requirements, system set-up, patient preparation, acquiring the data, and interpretation.

Graphic abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13

Similar content being viewed by others

Data availability

No data available.

References

  1. Collaborators GBDC (2020) The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol 5 (3):245–266. doi: https://doi.org/10.1016/S2468-1253(19)30349-8

    Article  Google Scholar 

  2. Estes C, Razavi H, Loomba R, Younossi Z, Sanyal AJ (2018) Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology 67 (1):123–133. doi: https://doi.org/10.1002/hep.29466

    Article  CAS  PubMed  Google Scholar 

  3. Berger D, Desai V, Janardhan S (2019) Con: Liver Biopsy Remains the Gold Standard to Evaluate Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Clin Liver Dis (Hoboken) 13 (4):114–116. doi: https://doi.org/10.1002/cld.740

    Article  Google Scholar 

  4. Davison BA, Harrison SA, Cotter G, Alkhouri N, Sanyal A, Edwards C, Colca JR, Iwashita J, Koch GG, Dittrich HC (2020) Suboptimal reliability of liver biopsy evaluation has implications for randomized clinical trials. J Hepatol 73 (6):1322–1332. doi: https://doi.org/10.1016/j.jhep.2020.06.025

    Article  CAS  PubMed  Google Scholar 

  5. Barsic N, Lerotic I, Smircic-Duvnjak L, Tomasic V, Duvnjak M (2012) Overview and developments in noninvasive diagnosis of nonalcoholic fatty liver disease. World J Gastroenterol 18 (30):3945–3954. doi: https://doi.org/10.3748/wjg.v18.i30.3945

    Article  PubMed  PubMed Central  Google Scholar 

  6. Selvaraj EA, Mozes FE, Jayaswal ANA, Zafarmand MH, Vali Y, Lee JA, Levick CK, Young LAJ, Palaniyappan N, Liu CH, Aithal GP, Romero-Gomez M, Brosnan MJ, Tuthill TA, Anstee QM, Neubauer S, Harrison SA, Bossuyt PM, Pavlides M, Investigators L (2021) Diagnostic accuracy of elastography and magnetic resonance imaging in patients with NAFLD: A systematic review and meta-analysis. J Hepatol 75 (4):770–785. doi: https://doi.org/10.1016/j.jhep.2021.04.044

    Article  PubMed  Google Scholar 

  7. Lefebvre T, Wartelle-Bladou C, Wong P, Sebastiani G, Giard JM, Castel H, Murphy-Lavallee J, Olivie D, Ilinca A, Sylvestre MP, Gilbert G, Gao ZH, Nguyen BN, Cloutier G, Tang A (2019) Prospective comparison of transient, point shear wave, and magnetic resonance elastography for staging liver fibrosis. Eur Radiol 29 (12):6477–6488. doi: https://doi.org/10.1007/s00330-019-06331-4

    Article  PubMed  Google Scholar 

  8. Cui J, Ang B, Haufe W, Hernandez C, Verna EC, Sirlin CB, Loomba R (2015) Comparative diagnostic accuracy of magnetic resonance elastography vs. eight clinical prediction rules for non-invasive diagnosis of advanced fibrosis in biopsy-proven non-alcoholic fatty liver disease: a prospective study. Alimentary Pharmacology and Therapeutics 41:1271–1280

    CAS  PubMed  Google Scholar 

  9. Hsu C, Caussy C, Imajo K, Chen J, Singh S, Kaulback K, Le MD, Hooker J, Tu X, Bettencourt R, Yin M, Sirlin CB, Ehman RL, Nakajima A, Loomba R (2019) Magnetic resonance vs. transient elastography analysis of patients with nonalcoholic fatty liver disease: a systematic review and pooled analysis of individual participants. Clinical Gastroenterology and Hepatology 17:630–637

    PubMed  Google Scholar 

  10. Liang Y, Li D (2020) Magnetic resonance elastography in staging liver fibrosis in non-alcoholic fatty liver disease: a pooled analysis of the diagnostic accuracy. BMC Gastroenterol 20 (1):89. doi: https://doi.org/10.1186/s12876-020-01234-x

    Article  PubMed  PubMed Central  Google Scholar 

  11. Yoon JH, Lee JM, Woo HS, Yu MH, Joo I, Lee ES, Sohn JY, Lee KB, Han JK, Choi BI (2013) Staging of hepatic fibrosis: comparison of magnetic resonance elastography and shear wave elastography in the same individuals. Korean Journal of Radiology 14 (2):202–212

    PubMed  PubMed Central  Google Scholar 

  12. Yoon JH, Lee JM, Joo I, Lee ES, Sohn JY, Jang SK, Lee KB, Han JK, Choi BI (2014) Hepatic fibrosis: prospective comparison of MR elastography and US shear-wave elastography for evaluation. Radiology 273 (3):772–782

    PubMed  Google Scholar 

  13. Shire NJ, Yin M, Chen J, Railkar RA, Fox-Bosetti S, Johnson SM, Beals CR, Dardzinski BJ, Sanderson SO, Talwalkar JA, Ehman RL (2011) Test–retest repeatability of MR elastography for noninvasive liver fibrosis assessment in Hepatitis C. Journal of Magnetic Resonance Imaging 34:947–955

    PubMed  Google Scholar 

  14. Trout AT, Serai S, Mahley AD, Wang H, Zhang Y, Zhang B, Dillman JR (2016) Liver stiffness measurements with MR elastography: agreement and repeatability across imaging systems, field strengths, and pulse sequences. Radiology 281 (3):793–804

    PubMed  Google Scholar 

  15. Serai SD, Obuchowski NA, Venkatesh SK, Sirlin CB, Miller FH, Ashton E, Cole PE, Ehman RL (2017) Repeatability of MR elastography of liver: a meta-analysis. Radiology 285 (1):92–100

    PubMed  Google Scholar 

  16. QIBA.

  17. Lim JK, Flamm SL, Singh S, Falck-Ytter YT, Association CGCotAG (2017) American Gastroenterological Association Institute Guideline on the role of elastography in the evaluation of liver fibrosis. Gastroenterology 152:1536–1543

    PubMed  Google Scholar 

  18. Horowitz JM, Kamel IR, Arif-Tiwari H, Asrani SK, Hindman NM, Kaur H, McNamara MM, Noto RB, Qayyum A, Lalani T (2017) ACR Appropriateness Criteria Chronic Liver Disease. Journal of the American College of Radiology 14:S103–S117

    PubMed  Google Scholar 

  19. Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, Harrison SA, Brunt EM, Sanyal AJ (2018) The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology 67 (1):328–357. doi: https://doi.org/10.1002/hep.29367

    Article  PubMed  Google Scholar 

  20. Menter A, Gelfand JM, Connor C, Armstrong AW, Cordoro KM, Davis DMR, Elewski BE, Gordon KB, Gottlieb AB, Kaplan DH, Kavanaugh A, Kiselica M, Kivelevitch D, Korman NJ, Kroshinsky D, Lebwohl M, Leonardi CL, Lichten J, Lim HW, Mehta NN, Paller AS, Parra SL, Pathy AL, Prater EF, Rahimi RS, Rupani RN, Siegel M, Stoff B, Strober BE, Tapper EB, Wong EB, Wu JJ, Hariharan V, Elmets CA (2020) Joint American Academy of Dermatology–National Psoriasis Foundation guidelines of care for the management of psoriasis with systemic nonbiologic therapies. J Am Acad Dermatol 82 (6):1445–1486. doi: https://doi.org/10.1016/j.jaad.2020.02.044

    Article  CAS  PubMed  Google Scholar 

  21. Allen AM, Shah VH, Therneau TM, Venkatesh SK, Mounajjed T, Larson JJ, Mara KC, Kellogg TA, Kendrick ML, McKenzie TJ, Greiner SM, Li J, Glaser KJ, Wells ML, Gunneson TJ, Ehman RL, Yin M (2020) Multiparametric Magnetic Resonance Elastography Improves the Detection of NASH Regression Following Bariatric Surgery. In: Hepatol Commun, vol 4. vol 2. pp 185–192. doi: https://doi.org/10.1002/hep4.1446

  22. Patel NS, Hooker J, Gonzalez M, Bhatt A, Nguyen P, Ramirez K, Richards L, Rizo E, Hernandez C, Kisseleva T, Schnabl B, Brenner D, Sirlin CB, Loomba R (2017) Weight loss decreases magnetic resonance elastography estimated liver stiffness in nonalcoholic fatty liver disease. Clinical Gastroenterology and Hepatology 15:463–464

    PubMed  Google Scholar 

  23. Higuchi M, Tamaki N, Kurosaki M, Inada K, Kirino S, Yamashita K, Hayakawa Y, Sekiguchi S, Osawa L, Takaura K, Maeyashiki C, Kaneko S, Yasui Y, Tsuchiya K, Nakanishi H, Itakura J, Enomoto N, Izumi N (2020) Changes of liver stiffness measured by magnetic resonance elastography during direct-acting antivirals treatment in patients with chronic hepatitis C. J Med Virol. doi: https://doi.org/10.1002/jmv.26490

    Article  PubMed  PubMed Central  Google Scholar 

  24. Chen J, Talwalkar JA, Yin M, Glaser KJ, Sanderson SO, Ehman RL (2011) Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography. Radiology 259:749–756

    PubMed  PubMed Central  Google Scholar 

  25. Costa-Silva L, Ferolla SM, Lima AS, Vidigal PVT, Ferrari TCA (2018) MR elastography is effective for the non-invasive evaluation of fibrosis and necroinflammatory activity in patients with nonalcoholic fatty liver disease. European Journal of Radiology 98:82–89

    PubMed  Google Scholar 

  26. Navin PJ, Hilscher MB, Welle CL, Mounajjed T, Torbenson MS, Kamath PS, Venkatesh SK (2019) The utility of MR elastography to differentiate nodular regenerative hyperplasia from cirrhosis. Hepatology 69 (1):452–454

    PubMed  Google Scholar 

  27. Navin PJ, Gidener T, Allen AM, Yin M, Takahashi N, Torbenson MS, Kamath PS, Ehman RL, Venkatesh SK (2020) The Role of Magnetic Resonance Elastography in the Diagnosis of Noncirrhotic Portal Hypertension. Clin Gastroenterol Hepatol 18 (13):3051–3053.e3052. doi: https://doi.org/10.1016/j.cgh.2019.10.018

    Article  CAS  PubMed  Google Scholar 

  28. Cannella R, Giambelluca D, Pellegrinelli A, Cabassa P (2021) Color Doppler Ultrasound in Portal Hypertension: A Closer Look at Left Gastric Vein Hemodynamics. J Ultrasound Med 40 (1):7–14. doi: https://doi.org/10.1002/jum.15386

    Article  PubMed  Google Scholar 

  29. Asrani SK, Talwalkar JA, Kamath PS, Shah VH, Saracino G, Jennings L, Gross JB, Venkatesh SK, Ehman RL (2014) Role of magnetic resonance elastography in compensated and decompensated liver disease. Journal of Hepatology 60:934–939

    PubMed  Google Scholar 

  30. Gidener T, Ahmed OT, Larson JJ, Mara KC, Therneau TM, Venkatesh SK, Ehman RL, Yin M, Allen AM (2020) Liver Stiffness by Magnetic Resonance Elastography Predicts Future Cirrhosis, Decompensation, and Death in NAFLD. Clin Gastroenterol Hepatol. doi: https://doi.org/10.1016/j.cgh.2020.09.044

    Article  PubMed  Google Scholar 

  31. Han MAT, Vipani A, Noureddin N, Ramirez K, Gornbein J, Saouaf R, Baniesh N, Cummings-John O, Okubote T, Setiawan VW, Rotman Y, Loomba R, Alkhouri N, Noureddin M (2020) MR elastography-based liver fibrosis correlates with liver events in nonalcoholic fatty liver patients: A multicenter study. Liver Int 40 (9):2242–2251. doi: https://doi.org/10.1111/liv.14593

    Article  PubMed  Google Scholar 

  32. Osman KT, Maselli DB, Idilman IS, Rowan DJ, Viehman JK, Harmsen WS, Harnois DM, Carey EJ, Gossard AA, LaRusso NF, Lindor KD, Venkatesh SK, Eaton JE (2020) Liver Stiffness Measured by Either Magnetic Resonance or Transient Elastography is Associated with Liver Fibrosis and is an Independent Predictor of Outcomes Among Patients With Primary Biliary Cholangitis. J Clin Gastroenterol. doi: https://doi.org/10.1097/MCG.0000000000001433

    Article  Google Scholar 

  33. Eaton JE, Sen A, Hoodeshenas S, Schleck CD, Harmsen WS, Gores GJ, LaRusso NF, Gossard AA, Lazaridis KN, Venkatesh SK (2020) Changes in Liver Stiffness, Measured by Magnetic Resonance Elastography, Associated with Hepatic Decompensation in Patients with Primary Sclerosing Cholangitis. Clin Gastroenterol Hepatol 18 (7):1576–1583.e1571. doi: https://doi.org/10.1016/j.cgh.2019.10.041

    Article  CAS  PubMed  Google Scholar 

  34. Bae JS, Lee DH, Yi NJ, Lee KW, Suh KS, Kim H, Lee KB, Choi Y (2020) Magnetic Resonance Elastography Versus Transient Elastography in the Prediction of Complications After Resection for Hepatocellular Carcinoma. Ann Surg. doi: https://doi.org/10.1097/sla.0000000000004576

    Article  PubMed  Google Scholar 

  35. Lee DH, Lee JM, Yi NJ, Lee KW, Suh KS, Lee JH, Lee KB, Han JK (2017) Hepatic stiffness measurement by using MR elastography: prognostic values after hepatic resection for hepatocellular carcinoma. Eur Radiol 27:1713–1721

    PubMed  Google Scholar 

  36. Ichikawa S, Motosugi U, Oguri M, Onishi H (2017) Magnetic resonance elastography for prediction of radiation-induced liver disease after stereotactic body radiation therapy. Hepatology 66 (2):664–665

    PubMed  Google Scholar 

  37. Talwalkar JA, Yin M, Venkatesh SK, Rossman PJ, Grimm RC, Manduca A, Romano AJ, Kamath PS, Ehman RL (2009) Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension. American Journal of Roentgenology 193:122–127

    PubMed  Google Scholar 

  38. Dillman JR, Serai SD, Trout AT, Singh R, Tkach JA, Taylor AE, Blaxall BC, Fei L, Miethke AG (2019) Diagnostic performance of quantitative magnetic resonance imaging biomarkers for predicting portal hypertension in children and young adults with autoimmune liver disease. Pediatric Radiology 49:332–341

    PubMed  PubMed Central  Google Scholar 

  39. Alsaied T, Possner M, Lubert AM, Trout AT, Szugye C, Palermo JJ, Lorts A, Goldstein BH, Veldtman GR, Anwar N, Dillman JR (2019) Relation of Magnetic Resonance Elastography to Fontan Failure and Portal Hypertension. Am J Cardiol 124 (9):1454–1459. doi: https://doi.org/10.1016/j.amjcard.2019.07.052

    Article  CAS  PubMed  Google Scholar 

  40. Motosugi U, Ichikawa T, Koshiishi T, Sano K, Morisaka H, Ichikawa S, Enomoto N, Matsuda M, Fujii H, Araki T (2013) Liver stiffness measured by magnetic resonance elastography as a risk factor for hepatocellular carcinoma: a preliminary case–control study. Eur Radiol 23:156–162

    PubMed  Google Scholar 

  41. Venkatesh SK, Yin M, Glockner JF, Takahashi N, Araoz PA, Talwalkar JA, Ehman RL (2008) MR elastography of liver tumors: preliminary results. American Journal of Roentgenology 190:1534–1540

    PubMed  Google Scholar 

  42. Venkatesh SK, Hoodeshenas S, Venkatesh SH, Dispenzieri A, Gertz MA, Torbenson MS, Ehman RL (2019) Magnetic resonance elastography of liver in light chain amyloidosis. Journal of Clinical Medicine 8:739

    CAS  PubMed Central  Google Scholar 

  43. Kim HJ, Kim B, Yu HJ, Huh J, Lee JH, Lee SS, Kim KW, Kim JK (2020) Reproducibility of hepatic MR elastography across field strengths, pulse sequences, scan intervals, and readers. Abdom Radiol (NY) 45 (1):107–115. doi: https://doi.org/10.1007/s00261-019-02312-9

    Article  Google Scholar 

  44. Calle-Toro JS, Serai SD, Hartung EA, Goldberg DJ, Bolster BD, Darge K, Anupindi SA (2019) Magnetic resonance elastography SE-EPI vs GRE sequences at 3 T in a pediatric population with liver disease. Abdominal Radiology 44:894–902

    PubMed  Google Scholar 

  45. Kim DW, Kim SY, Yoon HM, Kim KW, Byun JH (2019) Comparison of technical failure of MR elastography for measuring liver stiffness between gradient-recalled echo and spin-echo echo-planar imaging: a systematic review and meta-analysis. Journal of Magnetic Resonance Imaging

  46. Yin M, Talwalkar JA, Glaser KJ, Venkatesh SK, Chen J, Manduca A, Ehman RL (2011) Dynamic postprandial hepatic stiffness augmentation assessed with MR elastography in patients with chronic liver disease. American Journal of Roentgenology 197:64–70

    PubMed  Google Scholar 

  47. Hallinan JT, Alsaif HS, Wee A, Venkatesh SK (2015) Magnetic resonance elastography of liver: influence of intravenous gadolinium administration on measured liver stiffness. Abdominal Imaging 40:783–788

    PubMed  Google Scholar 

  48. Plaikner M, Kremser C, Zoller H, Steurer M, Glodny B, Jaschke W, Henninger B (2019) Does gadoxetate disodium affect MRE measurements in the delayed hepatobiliary phase? European Radiology 29:829–837

    CAS  PubMed  Google Scholar 

  49. Guglielmo FF, Venkatesh SK, Mitchell DG (2019) Liver MR elastography technique and image interpretation: pearls and pitfalls. RadioGraphics 39:1983–2002

    PubMed  Google Scholar 

  50. Wang K, Manning P, Szeverenyi N, Wolfson T, Hamilton G, Middleton MS, Vaida F, Yin M, Glaser K, Ehman RL, Sirlin CB (2017) Repeatability and reproducibility of 2D and 3D hepatic MR elastography with rigid and flexible drivers at end-expiration and end-inspiration in healthy volunteers. Abdominal Radiology 42:2843–2854

    PubMed  Google Scholar 

  51. Choi SL, Lee ES, Ko A, Park HJ, Park SB, Choi BI, Cho YY, Kannengiesser S (2020) Technical success rates and reliability of spin-echo echo-planar imaging (SE-EPI) MR elastography in patients with chronic liver disease or liver cirrhosis. Eur Radiol 30 (3):1730–1737. doi: https://doi.org/10.1007/s00330-019-06496-y

    Article  PubMed  Google Scholar 

  52. Kim DK, Yoon H, Han K, Kim J, Lee MJ, Kim S, Koh H, Han SJ, Shin HJ (2021) Effect of different driver power amplitudes on liver stiffness measurement in pediatric liver MR elastography. Abdom Radiol (NY). doi: https://doi.org/10.1007/s00261-021-03197-3

    Article  Google Scholar 

  53. Manduca A, Bayly PJ, Ehman RL, Kolipaka A, Royston TJ, Sack I, Sinkus R, Van Beers BE (2021) MR elastography: Principles, guidelines, and terminology. Magn Reson Med 85 (5):2377–2390. doi: https://doi.org/10.1002/mrm.28627

    Article  PubMed  Google Scholar 

  54. Singh S, Venkatesh SK, Wang Z, Miller FH, Motosugi U, Low RN, Hassanein T, Asbach P, Godfrey EM, Yin M, Chen J, Keaveny AP, Bridges M, Bohte A, Murad MH, Lomas DJ, Talwalkar JA, Ehman RL (2015) Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clinical Gastroenterology and Hepatology 13:440–451

    PubMed  Google Scholar 

  55. Kennedy P, Wagner M, Castera L, Hong CW, Johnson CL, Sirlin CB, Taouli B (2018) Quantitative elastography methods in liver disease: current evidence and future directions. Radiology 286 (3):738–763

    PubMed  Google Scholar 

  56. Joshi M, Dillman JR, Towbin AJ, Serai SD, Trout AT (2017) MR elastography: high rate of technical success in pediatric and young adult patients. Pediatric Radiology 47:838–843

    PubMed  Google Scholar 

  57. Serai SD, Trout AT (2019) Can MR elastography be used to measure liver stiffness in patients with iron overload? Abdominal Radiology 44:104–109

    PubMed  Google Scholar 

  58. Ghoz HM, Kroner PT, Stancampiano FF, Bowman AW, Vishnu P, Heckman MG, Diehl NN, McLeod E, Nikpour N, Palmer WC (2019) Hepatic iron overload identified by magnetic resonance imaging-based T2* is a predictor of non-diagnostic elastography. Quant Imaging Med Surg 9 (6):921–927. doi: https://doi.org/10.21037/qims.2019.05.13

    Article  PubMed  PubMed Central  Google Scholar 

  59. Gill HE, Lisanti CJ, Schwope RB, Kim J, Katz M, Harrison S (2021) Technical success rate of MR elastography in a population without known liver disease. Abdom Radiol (NY) 46 (2):590–596. doi: https://doi.org/10.1007/s00261-020-02652-x

    Article  Google Scholar 

  60. Silva AM, Grimm RC, Glaser KJ, Fu Y, Wu T, Ehman RL, Silva AC (2015) Magnetic resonance elastography: evaluation of new inversion algorithm and quantitative analysis method. Abdominal Imaging 40:810–817

    PubMed  Google Scholar 

  61. Venkatesh SK, Ehman RL (2014) Magnetic resonance elastography of liver. Magn Reson Imaging Clin N Am 22:433–446

    PubMed  Google Scholar 

  62. Motosugi U, Ichikawa T, Sano K, Sou H, Muhi A, Koshiishi T, Ehman RL, Araki T (2010) Magnetic resonance elastography of the liver: preliminary results and estimation of inter-rater reliability. Jpn J Radiol 28:623–627

    PubMed  PubMed Central  Google Scholar 

  63. Gandhi DB, Pednekar A, Braimah AB, Dudley J, Tkach JA, Trout AT, Miethke AG, Franck MD, Heilman JA, Dzyubak B, Lake DS, Dillman JR (2021) Assessment of agreement between manual and automated processing of liver MR elastography for shear stiffness estimation in children and young adults with autoimmune liver disease. Abdominal Radiology. doi: https://doi.org/10.1007/s00261-021-03073-0

    Article  PubMed  Google Scholar 

  64. Dzyubak B, Glaser K, Yin M, Manduca A, Ehman RL Automated Analysis of Hepatic MR Elastography Images with Motion Artifacts and Signal Inhomogenities. In: ISMRM, Salt Lake City, Utah, 2013.

  65. Dzyubak B, Venkatesh SK, Manduca A, Glaser KJ, Ehman RL (2016) Automated liver elasticity calculation for MR elastography. Journal of Magnetic Resonance Imaging 43:1055–1063

    PubMed  Google Scholar 

  66. Chen J, Allen AM, Therneau TM, Chen J, Li J, Hoodeshenas S, Chen J, Lu X, Zhu Z, Venkatesh SK, Song B, Ehman RL, Yin M (2021) Liver stiffness measurement by magnetic resonance elastography is not affected by hepatic steatosis. Eur Radiol. doi: https://doi.org/10.1007/s00330-021-08225-w

    Article  PubMed  PubMed Central  Google Scholar 

  67. Yin M, Talwalkar JA, Glaser KJ, Manduca A, Grimm RC, Rossman PJ, Fidler JL, Ehman RL (2007) Assessment of hepatic fibrosis with magnetic resonance elastography. Clinical Gastroenterology and Hepatology 5:1207–1213

    PubMed  PubMed Central  Google Scholar 

  68. Leitao HS, Doblas S, Garteiser P, d'Assignies G, Paradis V, Mouri F, Geraldes CFGC, Ronot M, Van Beers BE (2017) Hepatic fibrosis, inflammation, and steatosis: influence on the MR viscoelastic and diffusion parameters in patients with chronic liver disease. Radiology 283 (1):98–107

    PubMed  Google Scholar 

  69. Joshi M, Dillman JR, Singh K, Serai SD, Towbin AJ, Xanthakos S, Zhang B, Su W, Trout AT (2018) Quantitative MRI of fatty liver disease in a large pediatric cohort: correlation between liver fat fraction, stiffness, volume, and patient-specific factors. Abdominal Radiology 43:1168–1179

    PubMed  Google Scholar 

  70. Mariappan YK, Dzyubak B, Glaser KJ, Venkatesh SK, Sirlin CB, Hooker J, McGee KP, Ehman RL (2017) Application of modified spin-echo-based sequences for hepatic MR elastography: evaluation, comparison with the conventional gradient-echo sequence, and preliminary clinical experience. Radiology 282 (2):390–398

    PubMed  Google Scholar 

  71. Wang J, Glaser KJ, Zhang T, Shan Q, He B, Chen J, Yin M, Dzyubak B, Kugel JL, Kruse SA, Grimm RC, Venkatesh SK, Ehman RL (2018) Assessment of advanced hepatic MR elastography methods for susceptibility artifact suppression in clinical patients. Journal of Magnetic Resonance Imaging 47:976–987

    PubMed  Google Scholar 

  72. Yin M, Glaser KJ, Talwalkar JA, Chen J, Manduca A, Ehman RL (2016) Hepatic MR elastography: clinical performance in a series of 1377 consecutive patients. Radiology 278 (1):114–124

    PubMed  Google Scholar 

  73. Abe K, Takahashi A, Imaizumi H, Hayashi M, Okai K, Kanno Y, Sato N, Kenjo A, Marubashi S, Ohira H (2018) Utility of magnetic resonance elastography for predicting ascites in patients with chronic liver disease. Journal of Gastroenterology and Hepatology 33:733–740

    PubMed  Google Scholar 

  74. Wagner M, Corcuera-Solano I, Lo G, Esses S, Liao J, Besa C, Chen N, Abraham G, Fung M, Babb JS, Ehman RL, Taouli B (2017) Technical failure of MR elastography examinations of the liver: experience from a large single-center study. Radiology 284 (2):401–412

    PubMed  Google Scholar 

  75. Chen J, Yin M, Talwalkar JA, Oudry J, Glaser KJ, Smyrk TC, Miette V, Sandrin L, Ehman RL (2017) Diagnostic performance of MR elastography and vibration-controlled transient elastography in the detection of hepatic fibrosis in patients with severe to morbid obesity. Radiology 283 (2):418–428

    PubMed  Google Scholar 

  76. Murphy IG, Graves MJ, Reid S, Patterson AJ, Patterson I, Priest AN, Lomas DJ (2017) Comparison of breath-hold, respiratory navigated and free-breathing MR elastography of the liver. Magnetic Resonance Imaging 37:46–50

    PubMed  Google Scholar 

  77. Morin CE, Dillman JR, Serai SD, Trout AT, Tkach JA, Wang H (2018) Comparison of standard breath-held, free-breathing, and compressed sensing 2D gradient-recalled echo MR elastography techniques for evaluating liver stiffness. American Journal of Roentgenology 211:W279–W287

    PubMed  Google Scholar 

  78. Wang H, Tkach JA, Trout AT, Dumoulin CL, Dillman JR (2019) Respiratory-triggered spin-echo echo-planar imaging-based MR elastography for evaluating liver stiffness. Journal of Magnetic Resonance Imaging 50:391–396

    PubMed  Google Scholar 

  79. Boyarko AC, Dillman JR, Tkach JA, Pednekar AS, Trout AT (2021) Comparison of compressed SENSE and SENSE for quantitative liver MRI in children and young adults. Abdom Radiol (NY). doi: https://doi.org/10.1007/s00261-021-03092-x

    Article  Google Scholar 

  80. Loomba R, Cui J, Wolfson T, Haufe W, Hooker J, Szeverenyi N, Ang B, Bhatt A, Wang K, Aryafar H, Behling C, Valasek MA, Lin GY, Gamst A, Brenner DA, Yin M, Glaser KJ, Ehman RL, Sirlin CB (2016) Novel 3D magnetic resonance elastography for the noninvasive diagnosis of advanced fibrosis in NAFLD: a prospective study. American Journal of Gastroenterology 111:986–994

    PubMed  Google Scholar 

  81. Morisaka H, Motosugi U, Glaser KJ, Ichikawa S, Ehman RL, Sano K, Ichikawa T, Onishi H (2017) Comparison of diagnostic accuracies of two- and three-dimensional MR elastography of the liver. Journal of Magnetic Resonance Imaging 45:1163–1170

    PubMed  Google Scholar 

  82. Wang J, Shan Q, Liu Y, Yang H, Kuang S, He B, Zhang Y, Chen J, Zhang T, Glaser KJ, Zhu C, Chen J, Yin M, Venkatesh SK, Ehman RL (2019) 3D MR elastography of hepatocellular carcinomas as a potential biomarker for predicting tumor recurrence. Journal of Magnetic Resonance Imaging 49:719–730

    PubMed  Google Scholar 

  83. Shi Y, Qi YF, Lan GY, Wu Q, Ma B, Zhang XY, Ji RY, Ma YJ, Hong Y (2021) Three-dimensional MR Elastography Depicts Liver Inflammation, Fibrosis, and Portal Hypertension in Chronic Hepatitis B or C. Radiology 301 (1):154–162. doi: https://doi.org/10.1148/radiol.2021202804

    Article  PubMed  Google Scholar 

  84. Hirsch S, Guo J, Reiter R, Papazoglou S, Kroencke T, Braun J, Sack I (2014) MR elastography of the liver and the spleen using a piezoelectric driver, single-shot wave-field acquisition, and multifrequency dual parameter reconstruction. Magnetic Resonance in Medicine 71:267–277

    PubMed  Google Scholar 

  85. Allen AM, Shah VH, Therneau TM, Venkatesh SK, Mounajjed T, Larson JJ, Mara KC, Schulte PJ, Kellogg TA, Kendrick ML, McKenzie TJ, Greiner SM, Li J, Glaser KJ, Wells ML, Chen J, Ehman RL, Yin M (2020) The Role of Three-Dimensional Magnetic Resonance Elastography in the Diagnosis of Nonalcoholic Steatohepatitis in Obese Patients Undergoing Bariatric Surgery. Hepatology 71 (2):510–521. doi: https://doi.org/10.1002/hep.30483

    Article  PubMed  Google Scholar 

  86. Dzyubak B, Glaser K, Yin M, Talwalkar J, Chen J, Manduca A, Ehman RL (2013) Automated liver stiffness measurements with magnetic resonance elastography. Journal of Magnetic Resonance Imaging 38:371–379

    PubMed  Google Scholar 

  87. Dzyubak B, Venkatesh SK, Ehman RL Automated technique for hepatic MR Elastography analysis: comparison to skilled human interpretation. In: RSNA, Chicago, IL, 2013.

  88. Dzyubak B, Venkatesh SK, Glaser K, Ehman RL Clinical Validation of a Semiautomated Workflow for MR Elastography. In: ISMRM, Paris, France, 2018.

  89. Schwimmer JB, Behling C, Angeles JE, Paiz M, Durelle J, Africa J, Newton KP, Brunt EM, Lavine JE, Abrams SH, Masand P, Krishnamurphy R, Wong K, Ehman RL, Yin M, Glaser KJ, Dzyubak B, Wolfson T, Gamst AC, Hooker J, Haufe W, Schlein A, Hamilton G, Middleton MS, Sirlin CB (2017) Magnetic resonance elastography measured shear stiffness as a biomarker of fibrosis in pediatric nonalcoholic fatty liver disease. Hepatology 66 (5):1474–1485

    CAS  PubMed  Google Scholar 

  90. Dzyubak B, Li J, Chen J, Mara KC, Therneau TM, Venkatesh SK, Ehman RL, Allen AM, Yin M (2021) Automated Analysis of Multiparametric Magnetic Resonance Imaging/Magnetic Resonance Elastography Exams for Prediction of Nonalcoholic Steatohepatitis. J Magn Reson Imaging 54 (1):122–131. doi: https://doi.org/10.1002/jmri.27549

    Article  PubMed  Google Scholar 

Download references

Funding

Dr. Dillman acknowledges liver-related research support from Philips Healthcare, GE (General Electric) Healthcare, Perspectum Ltd, Siemens Healthineers and Canon Medical Solutions. Dr. Venkatesh acknowledges support from National Institute of Health Grant (EB001981) and U.S. Department of Defense grant (W81XWH-19–1-0583–01). Drs. Pepin, Welle and Guglielmo did not receive support from any organization for the submitted work

Author information

Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA

    Kay M. Pepin, Christopher L. Welle & Sudhakar K. Venkatesh

  2. Resoundant Inc, Rochester, MN, USA

    Kay M. Pepin

  3. Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA

    Flavius F. Guglielmo

  4. Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Jonathan R. Dillman

Authors
  1. Kay M. Pepin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher L. Welle
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Flavius F. Guglielmo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jonathan R. Dillman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sudhakar K. Venkatesh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sudhakar K. Venkatesh.

Ethics declarations

Conflict of interest

Financial interests Author KP is an employee of Resoundant, Inc. The other authors declare they have no financial interests.

Non-financial interests: None.

Ethical approval

This review article did not involve any research involving human participants and/or animals. No ethical approval was needed.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pepin, K.M., Welle, C.L., Guglielmo, F.F. et al. Magnetic resonance elastography of the liver: everything you need to know to get started. Abdom Radiol 47, 94–114 (2022). https://doi.org/10.1007/s00261-021-03324-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-021-03324-0

Keywords

Search

Navigation