Key takeaways:
- Liver disease can silently progress, only showing symptoms in the advanced stages.
- A liver MRI is capable of detecting many types of liver diseases, including liver cancer.
- Liver MRI takes from 10 to 30 minutes and does not need any special preparation.
- Early detection, using imaging tests like an MRI, may potentially offer a better prognosis.
In the US, liver disease and cirrhosis rank as the 10th leading cause of death overall in the US, with 54,803 deaths and a death rate of 16.4 per 100,000 population1.
The liver is the most resilient organ in the human body. So when there’s a problem with the liver, it’s usually not apparent until after it has progressed enough to cause symptoms.
Early detection of potential problems through imaging techniques like a liver MRI may help plan a successful treatment.
What Is An MRI of the Liver?
A liver MRI is actually an abdominal MRI that looks at all the organs in the abdominal area. It is a non-invasive diagnostic test that uses a powerful magnetic field and radio waves to produce detailed images of the liver.
These scans can be performed with or without contrast dye, which may be injected to enhance image clarity. MRI is particularly useful for2:
- Detecting liver diseases such as cirrhosis or fatty liver disease.
- Identifying tumors, including liver cancer.
- Assessing blood vessel abnormalities in the liver.
- Diagnosing inflammation or infection of the liver.
- Evaluating liver damage caused by alcohol or other toxins.
MRI scans of the liver offer several advantages, including high accuracy in diagnosing both cancerous and non-cancerous lesions and the ability to measure liver stiffness to detect fibrosis3. This makes liver MRI an essential tool for diagnosing, monitoring, and guiding treatment decisions for various liver conditions.
Understanding What Your Liver Does Before Scheduling an MRI
Before scheduling an MRI of the liver, it’s important to understand the vital functions this organ performs in the body. The liver is a remarkable organ that plays a crucial role in maintaining overall health and well-being.
Key Functions of the Liver
The liver is the largest solid organ in the body, located beneath the rib cage in the right upper abdomen. It performs over 500 vital functions, including4–6:
- Filtration and Detoxification: The liver filters all the blood in the body, removing toxins, drugs, and other harmful substances.
- Nutrient Processing: It breaks down, balances, and creates nutrients from the food we eat, regulating blood sugar levels and processing proteins, carbohydrates, and fats.
- Bile Production: The liver produces bile, which is essential for fat digestion and waste removal.
- Protein Synthesis: It creates important proteins such as albumin and blood clotting factors.
- Immune Support: The liver plays a role in fighting infections by removing bacteria from the bloodstream and producing immune factors.
- Storage: It stores vitamins (A, D, E, K, and B12), minerals (iron and copper), and glucose in the form of glycogen.
- Bilirubin Processing: The liver processes bilirubin, preventing jaundice.
What Does an MRI of the Liver Show?
MRI, or magnetic resonance imaging, can help detect certain liver disorders that affect this organ. These include hepatitis, hemochromatosis, and fatty liver disease. MRI scans also show blood flow, providing valuable information about any possible disorders of the vascular system associated with the liver7.
Liver MRI is also able to detect tumors in the liver. While these tumors may either be benign (hepatic adenomas) or cancerous (hepatocellular carcinoma), an MRI scan may, at times, be able to tell the difference.
When Would I Need a Liver MRI?
Liver diseases may potentially show up in a regular or elective blood test. LFTs, or liver function tests, are blood tests that detect certain enzymes or proteins in your blood that provide vital clues about the functioning of the liver8. Abnormal blood tests may prompt your healthcare practitioner to order an imaging test, like a liver MRI9.
In other cases, someone with liver disease may experience certain symptoms, such as10:
- Loss of appetite
- Weakness
- Nausea
- Build-up of fluid (ascites), leading to swelling of legs and abdomen
- Jaundice (yellow skin and whites of the eyes)
- Feeling very tired and weak all the time
Early detection is the key to helping reverse early-stage liver disease.
What Can an MRI of The Liver Tell You?
An MRI of the liver is a powerful diagnostic tool that can provide detailed information about various liver conditions and abnormalities.
Common Liver Disease
- Liver Disease: MRI can detect chronic liver diseases such as cirrhosis and fatty liver disease2.
- Tumors and Cancer: Both benign tumors and malignant cancers, including hepatocellular carcinoma and metastases, can be identified through liver MRI11.
- Vascular Abnormalities: MRI can reveal problems with blood vessels supplying the liver, such as blockages or narrowing12.
- Inflammation and Infection: Conditions like hepatitis can be visualized on MRI scans13.
- Iron Overload: MRI can quantify iron accumulation in the liver, which is associated with conditions like hemochromatosis14.
- Fatty Liver: MRI can accurately measure the amount of fat in the liver, helping diagnose conditions like non-alcoholic fatty liver disease (NAFLD)15.
- Fibrosis: Advanced MRI techniques can assess liver fibrosis, a key indicator of liver disease progression16.
Appearance on MRI
Different liver conditions have characteristic appearances on MRI scans.
- Cirrhosis: Appears as an irregular, nodular liver surface with changes in liver size and shape17.
- Fatty liver: This shows increased signal intensity on T1-weighted images and decreased signal on T2-weighted images18.
- Tumors: Malignant tumors often appear as masses with irregular borders and abnormal enhancement patterns after contrast administration.
- Hepatitis: Active inflammation may show increased enhancement during the arterial phase of contrast-enhanced MRI.
- Iron Overload: Causes decreased signal intensity on both T1 and T2-weighted images.
- Fibrosis: Advanced MRI techniques like MR elastography can visualize and quantify liver stiffness, which is indicative of fibrosis2.
MRI’s ability to provide detailed, multi-parametric information makes it an invaluable tool for liver assessment, often surpassing other imaging modalities in accuracy and comprehensiveness. Its non-invasive nature and lack of radiation exposure further increase its utility in diagnosing and monitoring liver conditions.
Different Ways To Detect Liver Disease
The most common imaging tests to detect liver problems are ultrasound, CT (computed tomography) scans, and MRI scans19.
Which modality is used depends on the patient's risk category. For instance, for patients at high risk of liver cancer (the high-risk category also includes those with cirrhosis and chronic hepatitis B virus infection), the lesion size determines the imaging test.
For patients with lesions measuring <1 cm in diameter, monitoring is done using ultrasound every three to six months for one to two years20.
For a lesion ≥1 cm, a dynamic contrast-enhanced CT or MRI of the abdomen specific for liver lesion characterization is performed.
In some cases, your medical practitioner may also ask you to get a biopsy done. A liver biopsy is a process in which a small part of the liver is surgically removed using a minimally invasive technique21. This liver tissue is then investigated in the lab to provide a better understanding of how the cells are and the extent of the damage to them.
In high-risk patients, HCC (hepatocellular carcinoma, the most common type of liver cancer) can sometimes be diagnosed with the help of imaging alone, without the need for a biopsy22.
MRI vs CT Scan for Spleen Imaging
Both CT and MRI scans have their own advantages and shortcomings in assessing liver health. For instance, one review compared the roles of different imaging tests in assessing liver cancer23.
Both CT and MRI performed similarly at detecting liver cancer.
The review showed that a CT scan outperformed an MRI when it came to observing the abdominal area surrounding the liver (extra-hepatic abdomen). However, the CT procedure assessed was performed with a contrast agent, which gives better image enhancement.
If a patient has an allergy to contrast dye or has a kidney problem where contrast agents can’t be used, MR imaging is usually preferred to CT to detect malignancy24.
The way in which CT and MRI scans work is different. CT scans make use of X-rays to scan the inside of the body, so they may risk exposing the patient to ionizing radiation25.
MRI scans, on the other hand, use a combination of radio waves and strong magnetic fields to create an image of soft tissues, bones, and joints26. They don’t use ionizing radiation, making them safer.
There have been a lot of advancements in MRI technology, offering this modality better detection capabilities and increasing its spectrum of use.
For example, a recently concluded clinical trial assessed the validity and effectiveness of advanced MRI methods for detecting cirrhosis and fibrosis in patients27. A liver biopsy is usually the test of choice in such advanced cases28.
However, problems associated with a biopsy, such as cost, invasiveness, issues with repeatability, and poor patient acceptance, have necessitated the use of non-invasive, safe, accurate, and faster methods, like liver MRI.
When choosing one imaging method over another, the risk-benefit ratio is considered, and medical practitioners will make an informed recommendation on which imaging test to use and when.
How Long Does a Liver MRI Take?
Liver imaging and abdominal imaging usually take between 10 to 30 minutes.
While the preparatory and actual scan times are usually fixed, the total amount of time required to complete the scan will depend greatly on your ability to stay absolutely still. Sudden movements cause blurred images, which means the scan may need to be repeated.
When undergoing a scan with contrast, it takes time to inject the contrast agent through an intravenous injection and for uptake of the injected chemical inside your body.
Sometimes, a liver MRI is done using liver-specific contrast agents like gadobenate dimeglumine or gadoxetic acid29.
Preparing for a Liver MRI
An MRI examination is a fast, non-invasive, and painless procedure that takes little preparation.
Do not wear any makeup or jewelry to your MRI as they may interfere with the machine's strong magnetic field. If you have any metallic implants like a pacemaker, dental or cochlear implants, or prosthesis, let your healthcare team and radiology practitioner know so that they can plan accordingly.
If your healthcare practitioner has ordered a liver MRI with contrast, you’ll be injected with a specific gadolinium-based contrast agent. A contrast-enhanced liver MRI is helpful in evaluating chronic disease as well as focal liver lesions (a localized group of abnormal cells).
If you are allergic to gadolinium or have any kind of allergy, you should let your care team know.
Note: Ezra offers scans with and without contrast. However, when the liver is being scanned, Ezra won’t use contrast.
At Ezra, we ask you to come at least 30 minutes prior to your scheduled time. Your Ezra Care Advisor will be with you throughout your entire scan experience—from taking your medical history to helping you go through your results.
We provide a fresh set of pajamas to change into, and once you’re inside the scanning lounge, we offer you a pair of earmuffs to help reduce the noise the MRI machine usually makes. At select partner facilities, we can also play your favorite Spotify® playlist to help you relax during the course of the scan.
Once the procedure is done, you can change into your clothes and get back to your work. Once the report is ready, a licensed Ezra Medical Provider will get in touch with you to schedule a call to help you understand your results and guide you through any next steps.
How To Find An MRI Center
Selecting an appropriate MRI provider is essential for obtaining accurate results and high-quality care. Begin by consulting your physician to determine if an MRI is necessary and which type is most suitable for your specific needs. When choosing a provider, consider factors such as accreditation, radiologist qualifications, advanced technology, convenience, and cost.
Partnering with established imaging specialists and accredited facilities can provide access to state-of-the-art technology and skilled radiologists. This ensures high-quality scans with expert interpretations, leading to more accurate and reliable results for your healthcare needs. It’s important to take a proportionate approach when selecting a provider, ensuring that the decision-making process is reasonable and defensible.
Early Detection and Lifestyle Changes: Keys to Reversing Liver Diseases
Early detection empowers you to take control of your health and plan a successful treatment or reversal of the disease.
Chronic liver diseases, if detected in the early stages, are relatively easy to reverse if supportive lifestyle changes are implemented. That’s why it’s important to know that a liver MRI can help catch potential medical issues early.
We have designed the Ezra Full Body, an MRI-based scan service, to screen for signs of cancer and other abnormalities in all the major organs of the body. It scans up to 13 organs and is priced at $2,395 (or $84 a month), and the Ezra Full Body Plus scans up to 14 organs and is priced at $2,695 (or $94 a month). The Ezra Blueprint is our most advanced longevity scan, and it is priced at $5,995 (or $208 a month).
The Ezra Scan also includes a 45-minute consultation with a Medical Provider and mid-year check-ins. Check out your nearest Ezra location.
Take control of your health and book a scan today. To know your risk of cancer, take our 5-minute quiz.
