MRI of the liver

MRI of the liver is a method of magnetic resonance imaging that is used in situations where it is necessary to establish, differentiate or clarify the diagnosis of liver pathology. This is a very effective diagnostic procedure, lasting no more than 40 minutes.

MRI is based on the use of magnetic properties of protons distributed in all parts of the body. In clinical practice, T1 and T2 images are used. T1 imaging measures the rate at which protons return to their original position in an external magnetic field after a radiofrequency pulse. T2 imaging measures the rate at which protons leave the state of unidirectional axes due to the difference in electromagnetic influences of neighboring protons (the rate of radio wave decrease).

MRI of the liver allows differentiation of tissues containing different amounts of fat and water, accurate assessment of blood flow and has high resolution in the differential diagnosis of cirrhotic regenerative nodes and hepatocellular carcinoma.

Currently, magnetic resonance cholangiography is increasingly used, allowing visualization of intra- and extrahepatic bile ducts, which is used in the diagnosis of primary sclerosing cholangitis and “subhepatic” jaundice.

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Indications for use of MRI of the liver

MRI of the liver reliably determines pathologies of the gallbladder and bile ducts, as well as liver diseases. The study helps to detect:

• liver abscess;
• fatty degeneration of liver tissue;
• signs of cirrhosis;
• benign tumors;
• hepatocerebral dystrophy;
• damage to liver tissue as a result of injury;
• gallbladder stones.

Most often, the MRI procedure is used in the following situations:

• if there is a suspicion of gallstones;
• for jaundice of non-infectious etiology;
• if there is a suspicion of cancer;
• with significant changes in the size of the liver;
• if there is a possibility of the formation of cancer metastases in the liver;
• for pain in the liver area of unknown origin.

Often, when treating oncological pathologies, MRI of the liver is used to monitor the effectiveness of the therapy.

Using magnetic resonance imaging, the liver can be examined using pancreatocholangiography or cholecystocholangiography. The procedures allow one to determine malignant liver damage and monitor the processes occurring in the organ.

Often, MRI involves the use of a contrast agent, which allows one to distinguish between a disrupted liver structure and tissue swelling.

Preparation for MRI of the liver

If you have a medical referral for an MRI of the liver, don’t worry: this procedure is completely safe for your body. In addition, preparing for an MRI of the liver is not that difficult. Here’s what patients need to know before the procedure:

• Before magnetic resonance imaging of the liver, you should refrain from eating and drinking for 5 hours before the procedure. Why is this necessary? So that the gallbladder is filled to its maximum capacity at the time of the examination;
• If you are about to undergo an MRI of the liver with contrast, remember the following:
  • Avoid foods that cause flatulence for 24 hours;
  • do not eat sweets or baked goods for 2-3 days;
  • On the day the examination is planned, it is better not to eat anything, or drink tea or coffee;
  • the last meal should occur no later than six hours before the examination;
  • if flatulence is still present, you must tell your doctor about it in advance and take the pill prescribed by your doctor (for example, activated charcoal, white charcoal, espumisan);
  • 30 minutes before the examination, it is recommended to take an antispasmodic drug (for example, no-shpa);
  • Before going to the procedure, take with you all the necessary documents (usually these are the results of previous studies).

The following aspects should also be kept in mind:

• When you go to the procedure, do not wear clothes with metal elements (buttons, snaps, etc.). Otherwise, you will be asked to change;
• During the examination, you must remove your wristwatch, necklace, earrings, and rings;
• It is advisable not to use cosmetics, as many products may contain metals;
• You should not take any electrical devices or payment cards with you - they may be damaged by magnetic fields.

Tell the specialist who will conduct the examination if you have metal implants, prostheses, pins, etc. in your body. Some tattoos also contain metal (in the form of paint), which can irritate the skin. Sometimes the patient is examined with a metal detector before the procedure.

How is an MRI of the liver performed?

Currently, there are tomographs in open and closed (tunnel) versions. One of the most common is the tunnel device. Its disadvantage is that the patient has to stay in a closed space for a long time, which can present certain difficulties, in particular, a feeling of discomfort.

An open apparatus is a room resembling an X-ray room. During open-type examinations, you can approach the patient, see his condition, talk: this is especially important when performing the procedure on elderly patients and children.

The study allows you to examine the required organ (in this case, the liver) in the form of a section. Therefore, tomographic results are usually presented on a large surface with numerous images of each layer of the organ.

The procedure itself can last about 30-40 minutes, in rare cases – up to 1.5 hours.

The subject is placed in the tunnel of the device. There he must remain motionless during the entire procedure, because any movement can negatively affect the quality of the photographs.

For a more comfortable stay of the patient, air circulation is built in the tunnel and lighting is installed. The procedure, as a rule, does not contribute to changes in well-being or any unpleasant symptoms.

Prior to the procedure, the patient may be given a contrast agent, depending on the need and the doctor's instructions.

MRI of the liver with contrast

Currently, there are two main types of MRI of the liver with contrast:

• the first option involves a single intravenous injection of the substance before the MRI procedure. The calculation of the administered drug is made based on the ratio of 0.2 mg per kilogram of the patient's weight;
• the second option involves intravenous drip administration of the substance. Using a special dosing device, it is possible to control the dosage of the administered contrast agent during the tomography procedure. This option of administration is also called bolus contrasting, it is used in dynamic MRI with the use of contrast.

The use of a contrast agent during an MRI procedure is possible when a neoplasm is detected, to determine its size, structure and outline. Thanks to the contrast, it is possible to clearly detail the organ being examined.

The substance is usually administered into a vein: this injection does not pose any danger to the body.

The following contrast agents can be used for MRI of the liver:

• "Omniscan";
• "Magnevist";
• "The Nasty One";
• "Primovist";
• "Dotarem".

These drugs are synthesized from a chelate complex of gadolinium, they do not have any toxicity and are not accompanied by the development of side effects. Allergic reactions to these drugs occur extremely rarely. However, if there is a suspicion of the possibility of developing an allergy, contrast agents are not used for such a patient.

MRI of the liver with Primovist

Surgical treatment of liver tumors is becoming more successful and effective every year. One of the reasons for this is the use of new visualization techniques using hepatotropic contrast agents.

The innovative contrast agent "Primovist" contains gadoxetic acid, which has tropism for hepatocytes. After injection of Primovist into a vein, the agent reaches the liver cells quite quickly through the bloodstream. In this case, it becomes possible to diagnose not only liver pathology, but also bile ducts.

Thanks to Primovist, in one MRI procedure it is possible to determine the presence of a liver tumor, recognize the benign or malignant nature of the process, detect the presence of metastases, and distinguish the parent liver tumor from secondary metastasis.

According to the conducted studies, the use of liver MRI with Primovist may become one of the most preferable diagnostic methods, both from a medical and economic point of view.

The use of Primovist helps to reach a completely new level of MRI of the liver and biliary tract, thereby increasing the quality and reliability of the diagnosis.

Contraindications to MRI of the liver

Absolute contraindications to MRI of the liver include:

• presence of a pacemaker;
• installed Elizarov metal frame apparatus;
• implants made of metal;
• electronic implants;
• the presence of clamps on the blood vessels of the brain.

Relative contraindications include:

• the presence of artificial stimulants of the nervous system;
• the presence of a device for regular insulin administration;
• coronary artery bypass grafting, replacement of a heart valve with an artificial one;
• presence of fixed dentures;
• decompensated stage of coronary heart disease;
• first trimester of pregnancy;
• phobia of being in a confined space;
• some mental illnesses;
• state of alcohol or drug intoxication;
• excessive excess weight (more than 150 kg);
• critical health condition of the patient.

Taking into account that the patient will have to remain completely immobilized during the entire examination, general anesthesia may be used for some patients. Anesthesia is used:

• when examining small children;
• during panic attacks or epilepsy;
• in case of mental health disorders;
• in case of severe pain that does not allow you to take the necessary relaxed body position;
• if you have claustrophobia.

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Price of MRI of the liver

The cost of an MRI of the liver procedure may vary depending on the characteristics of the tomography equipment provided, as well as the specifics of a particular medical center. We have collected information on average price requests for this procedure in the capital:

• MRI of the abdominal cavity (liver) – $90-110;
• MRI of the gallbladder and bile ducts – $60-70;
• additional MRI with contrast – $150;
• MRI of the liver using the patient's contrast agent - $130;
• additional MRI with patient contrast – $80;
• recording the results of liver MRI on film – $8-9;
• duplicate of liver MRI results on disk or other storage media – $4-5.

If a specialist consultation is required to read and decipher the results, such a service is usually paid for additionally. Some medical institutions may offer discounts and promotions on diagnostic procedures, including liver MRI, which must be clarified when paying for the study.