MRI of the liver

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

The basis of MRI is the use of magnetic properties of protons distributed in all parts of the body. In clinical practice, T1 and T2 images are used. At the T1-image, the rate of return of protons to the initial position in an external magnetic field after a radio-frequency pulse is measured. At the T2-image, the proton yield rate from the unidirectional state of the axes is measured due to the difference in the electromagnetic influences of neighboring protons (the rate of reduction of the radio wave).

MRI of the liver makes it possible to differentiate tissues containing a different amount of fat and water, accurately estimate the blood flow and has greater resolving power in the differential diagnosis of cirrhotic regenerative nodes and hepatocellular carcinoma.

Currently, magnetic resonance cholangiography is increasingly used to visualize intra- and extrahepatic bile ducts, which is used in the diagnosis of primary sclerosing cholangitis, "subhepatic" jaundice.

[1], [2], [3], [4]

Indications for the use of MRI of the liver

MRI of the liver reliably determines the pathology of the gallbladder and biliary tract, as well as liver disease. Research helps to detect:

• hepatic abscess;
• fatty degenerations of hepatic tissues;
• signs of cirrhosis;
• benign tumors;
• hepatocerebral dystrophy;
• damage to liver tissue as a result of trauma;
• gallstones.

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

• if there is a suspicion of gallstones;
• with jaundice of non-infectious etiology;
• at suspicion of oncological disease;
• with a significant change in liver size;
• with the possibility of forming cancerous metastases in the liver;
• with pain in the region of the liver of an incomprehensible genesis.

Often in the treatment of oncological pathologies, liver MRI is used to monitor the effectiveness of the therapy.

With the help of magnetic resonance imaging, the liver can be examined by the method of pancreatocholangiography or cholecystocholangiography. The procedures allow to determine the malignant liver damage, to control the processes that occur in the organ.

Often, with MRI resort to the use of contrast agent, which allows you to distinguish the damaged structure of the liver from swelling of the tissues.

Preparation for MRI of the liver

If you have a medical direction for MRI of the liver, do not worry: for your body this procedure is completely safe. In addition, the preparation for MRI of the liver is not that difficult. Here is what the patients need to know before the procedure:

• before magnetic resonance examination of the liver should refrain from eating food and liquid for 5 hours before the procedure. What is it for? To fill the gallbladder at the time of the study was maximum;
• if you are going to perform an MRI of the liver with a contrast, remember the following:
  • for 24 hours, give up the food that causes flatulence;
  • for 2-3 days do not eat sweets and buns;
  • on the day when the study is planned, it is better not to eat anything, not to drink tea and coffee;
  • the last eating should occur no later than six hours before the study;
  • if flatulence is still present, you must tell the doctor about it in advance and take a pill prescribed by your doctor (for example, activated charcoal, white coal, espumizan);
  • 30 minutes before the examination, it is recommended to take an antispasmodic drug (eg, no-shpu);
  • Before you go to the procedure, bring along all the necessary documents (usually the results of previous studies).

The following aspects should be borne in mind:

• when you go to the procedure, do not wear clothes with metal elements (buttons, latches, etc.). Otherwise, you will be offered to change;
• for the time of research it is necessary to remove the wristwatch, chain, earrings, rings;
• it is advisable not to use cosmetics, since many means can include metals;
• Do not take with you any electrical devices and payment cards - they can be damaged by magnetic fields.

Tell the specialist who will conduct the study if there are metal implants, prostheses, pins, etc. In your body. Some tattoos also include metal (in the form of a paint), which can cause skin irritation. Sometimes, before the procedure, the patient is examined using a metal detector.

How is MRI of the liver performed?

At the moment there are devices-tomographs in the open and closed (tunnel) version. One of the most common is the tunnel machine. Its downside is that the patient has to stay in the confined space for a long time, which can present certain difficulties, in particular, a feeling of discomfort.

The open device is a room resembling an X-ray room. When researching an open type, you can approach the patient, see his condition, talk: this is especially important when performing the procedure in elderly patients and children.

The study allows you to consider the necessary organ (in this case, the liver) in the form of a cut. Therefore, tomographic results are usually presented on a large surface with numerous photographs of each layer of the organ.

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

The examinee is placed in the tunnel of the apparatus. There, it must remain stationary during the whole procedure, because any movements can adversely affect the quality of the photographs.

For a more comfortable patient stay in the tunnel, air circulation is installed and lighting is installed. The procedure, as a rule, does not contribute to a change in the state of health and any unpleasant symptoms.

Before the procedure, the patient can be given a contrast preparation, depending on the need and on the instructions of the doctor.

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 start of the MRI procedure. Calculation of the injected drug is made from the ratio of 0.2 mg per kilogram of weight of the examined patient;
• the second option involves intravenous drip introduction of the substance. By means of a special metering device, it is possible to control the dosage of the contrast medium administered during the tomography procedure. This variant of administration is also called bolus contrast, it is used for dynamic MRI with contrast.

The use of contrast medium in the procedure of MRI is possible when a tumor is detected, to determine its size, structure and shape. Due to the contrast, the organ under study can be clearly detailed.

The administration of the substance is usually carried out in a vein: this injection does not pose any danger to the body.

For MRI of the liver, the following contrast agents can be used:

• Omniskan;
• "Magnevist";
• "Gadovist";
• "Primaver";
• "Dotar".

These drugs are synthesized from the gadolinium chelate complex, they do not have any toxicity and are not accompanied by the development of a side effect. Allergic manifestations in response to these drugs are extremely rare. However, if there is a suspicion of the possibility of developing an allergy, contrast preparations are not used for such a patient.

MRI of liver with prima

Operative treatment of liver tumors every year is more successful and effective. One of the reasons for this is the use of new imaging techniques with hepatotropic contrast agents.

Innovative contrast agent "Primovist" contains gadoxetic acid, which has a tendency to hepatocytes. After Primovist's injection into the vein, the means by means of the blood flow quickly reaches the liver cells. It becomes possible to diagnose not only the pathology of the liver, but also the biliary tract.

Thanks to Primovist, one can determine the presence of a liver tumor in one procedure of MRI, recognize the goodness or malignancy of the process, detect the presence of metastases, distinguish the maternal neoplasm of the liver from secondary metastasis.

According to the studies, the use of MRI of the liver with Primovitis can be one of the most preferred diagnostic techniques, both from a medical and an economic point of view.

Using Primavista promotes the emergence of a completely new level of MRI of the liver and biliary tract, thereby increasing the quality and reliability of the diagnosis.

Contraindications for MRI of the liver

The absolute contraindications for the MRI of the liver include:

• presence of a pacemaker;
• installed steel frame Elizarova;
• implants made of metal;
• electronic implants;
• presence of clamps on the vessels of the brain.

Relative contraindications include:

• presence of artificial stimulators of the nervous system;
• the presence of a device for regular administration of insulin;
• Coronary bypass, replacement of the heart valve with an artificial one;
• presence of non-removable prostheses;
• decompensated stage of ischemic heart disease;
• the first trimester of pregnancy;
• phobia of being in confined space;
• some mental illness;
• the state of alcoholic or narcotic intoxication;
• excessive excess weight (more than 150 kg);
• critical state of health of the patient.

Paying attention to the fact that the patient will be in a state of complete immobility during the whole course of the study, general anesthesia can be used for some patients. To anesthesia resort:

• when examining small children;
• at attacks of panic attacks or an epilepsy;
• mental health disorders;
• with severe pain, not allowing to take the necessary relaxed position of the body;
• in the presence of claustrophobia.

[5], [6]

Price MRI of the liver

The cost of the MRI procedure of the liver may vary depending on the characteristics of the provided tomography equipment, as well as the specificity of the specific medical center. We collected information on the 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;
• fixation of the result of MRI of the liver on the film - $ 8-9;
• duplicate the result of MRI of the liver on a disk or other storage medium - $ 4-5.

If you need a consultation specialist on reading and deciphering the results, then this service is paid, as a rule, additionally. Some medical institutions can conduct discounts and promotions for diagnostic procedures, including liver MRI, which must be specified when paying for the study.