title: [Value of magnetic resonance imaging in diffuse liver diseases].
abstract: OBJECTIVE
  Diffuse liver diseases show an increasing prevalence. The diagnostic gold standard of liver biopsy has several disadvantages. There is a clinical demand for non-invasive imaging-based techniques to qualitatively and quantitatively evaluate the entire liver.
  
  
  METHODS
  Ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) are routinely used.
  
  
  METHODS
  Steatosis: chemical shift and frequency selective imaging, MR spectroscopy (MRS). Hemochromatosis: MR-based iron quantification. Fibrosis: MR elastography, diffusion, intravoxel incoherent motion (IVIM) and MR perfusion.                                               PERFORMANCE/ACHIEVEMENTS/PRACTICAL RECOMMENDATIONS:                          T1-weighted in and opposed phase imaging is the clinically most frequently used MR technique to noninvasively detect and quantify steatosis. New methods for quantification that are not influenced by confounders like iron overload are under investigation. The most sensitive method to measure the fat content of the liver is MRS. As data acquisition and analysis remain complex and there is no whole organ coverage, MRS of the liver is not a routine method.                         With an optimized protocol incorporating T2* sequences, MRI is the modality of choice to quantify iron overload in hemochromatosis.                         Standard MR sequences cannot depict early stages of liver fibrosis. Advanced MR techniques (e.g. elastography, diffusion, IVIM and perfusion) for noninvasive assessment of liver fibrosis appear promising but their role has to be further investigated.
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistrasse 15, Munich, Germany. Nicolai.Schramm@med.uni-muenchen.de
authors.forename: N
authors.initials: N
authors.lastname: Schramm
authors.forename: M
authors.initials: M
authors.lastname: D'Anastasi
authors.forename: M F
authors.initials: MF
authors.lastname: Reiser
authors.forename: C J
authors.initials: CJ
authors.lastname: Zech
mesh_terms: D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*