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Liver MRI: What it’s for and what to expect

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 U.S, liver disease accounts for the second-highest number of deaths among all gastrointestinal diseases.

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 in planning a successful treatment.

What does an MRI of the liver show?

Liver MRI: doctor operating an MRI machine for a patient

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 liver.

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?

Medical workers looking at a tablet

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 liver. Abnormal blood tests may prompt your health care practitioner to order an imaging test, like a liver MRI.

In other cases, someone with liver disease may experience certain symptoms, such as:

  • Loss of appetite
  • Weakness
  • Nausea
  • Build-up of fluid (ascites), leading to swelling of legs and abdomen
  • Jaundice

However, these symptoms are apparent only when the liver disease is in the advanced stages, in which case a poor prognosis is more likely. Thus, early detection is the key to helping reverse a liver disease that has not progressed much.

Different ways to detect liver disease.

The most common imaging tests to detect liver problems are ultrasound, CT (computed tomography) scans, and MRI scans.  

Which modality is used depends on the risk category of the patient. For instance, 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 years. 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 technique. 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 biopsy.

How medical practitioners choose between liver MRIs and CT scans.

Both CT and MRI scans have their own advantages and shortcomings in assessing liver health. For instance, a review compares the roles of different imaging tests in assessing liver cancer. Both CT and MRI performed similarly at detecting liver cancer. 

The review showed CT scan outperforms MRI when it comes 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. 

In case a patient has an allergy to the contrast dye or has a kidney problem, a contrast agent can’t be used and the accuracy of the CT suffers. In such cases, MR imaging is preferred to detect malignancy.

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 radiation. 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 joints. 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 patients. A liver biopsy is usually the test of choice in such advanced cases. 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.  

Finally, while using one over the other, the risk-benefit ratio is considered and medical practitioners will make an informed recommendation on which imaging test to use when. 

How long does a liver MRI take?

Liver MRI: elderly man talking to a doctor

A liver MRI is actually an abdominal MRI that looks at all the organs in the abdominal area. Liver imaging and abdominal imaging usually takes 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 a great deal 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 acid.  

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 strong magnetic field of the machine. If you have any metallic implants like a pacemaker, dental or cochlear implants, or prosthesis, let your health care team and radiology practitioner know so that they can plan accordingly.

If your health care 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 are free to 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.

Early detection and lifestyle changes: Keys to reversing liver diseases.

Cute couple standing by a window

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 comparatively easy to reverse if supporting lifestyle changes are deployed. That’s why it’s important to know that a liver MRI can help catch potential medical issues early.

We have designed the Ezra Scan, an MRI-based scan service, to screen for signs of cancer and other abnormalities in all the major organs of the body. The Ezra Full Body scans up to 13 organs and is priced at $1,450 (or $125 a month) and the Ezra Full Body Plus is our most advanced service that scans up to 14 organs and is priced at $1,850 (or $165 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 easy quiz here.