Cirrhosis is a liver disease with varying stages of hepatocellular necrosis and inflammation. There is also fibrosis with fat and iron deposition. It results in visual manifestations which use imaging biomarkers, such as magnetic resonance imaging (MRI), for clinical application. Continuing research on this front is becoming more complex, empowering healthcare professionals like you to treat more patients. But what exactly should you note about this procedure?
This article will discuss two crucial factors about MRI and cirrhosis diagnosis facts to guide you through the procedure. Take this as an opportunity to guarantee you are doing what you can to address your patients’ medical conditions and make proper use of your high-quality medical imaging equipment. This way, you can gain legitimacy as a reputable hospital or clinic in your local community.
Fact #1: MRIs are primarily used for tumor development, but they can also detect early stages of chronic hepatitis and cirrhosis
Most patients with cirrhosis are often biopsied to determine the severity and locate internal problem areas. However, there are cases when it is unnecessary, especially if the laboratory and radiological data have significant findings. Additionally, MRI can be the right procedure for early stages of hepatocellular carcinoma (HCC) through ultrasound, conventional MRI, and computed tomography, which is not sensitive to early parenchymal changes.
New MRI modifications can also allow you to see iron and fat deposition, necroinflammatory infiltrate, fibrosis, hepatocyte functionality, and regenerative nodules. This approach to diagnosis is best accomplished through the professional assistance of a radiologist, enabling your healthcare facility to make the necessary preventive measures for avoiding chronic or late stages, such as through lifestyle changes and medical treatment.
Fact #2: An all-in-one, MRI-based evaluation requires a sequential order.
The efficient use of MRI equipment for cirrhosis evaluation requires the following steps: gradient-echo (GRE) sequencing for T1-weighted (T1W) images, dual-echo sequencing for fat analysis, and multi-echo GRE sequencing to measure iron. T2 correction can also be used alternatively for fat due to its more detailed calculations, but it depends on the radiologist’s discretion.
The respiratory-focused short T1 inversion recovery turbo spin-echo (STIR TSE) images must be set for the liver’s signal intensity and its closeness to subcutaneous fat and paraspinal muscles. It can be your reference for necro-inflammatory activity. Then, you can proceed to the T1 GRE examinations with fat suppression in mind to isolate tumor development and grade esophageal varices.
Just remember to manage the portal and equilibrium phases with the bolus arterial interval time for the late arterial. This way, you can use maximum intensity projection vascular map projections to see the collateral vessels and abnormal regions.
Don’t forget to use the temporal resolution to determine the pharmacokinetic model parameters with a dual input double compartment model. It should be five seconds for each image for approximately five minutes or more with a voxel-wise statistical analysis in mind. You can use contrast media of the low dose kind and utilize the bolus arrival time to have a high-resolution sequence.
Remember that the fat suppression T1W-spoiled GRE reading is received after half an hour to an hour next to the hepatobiliary contrast media, giving crucial information on the hepatocyte functionality. Meanwhile, the T2 GRE images from the superparamagnetic iron oxide particle liver enhancement can be a reference for disregarding HCC and depicting worsening fibrosis.
As you can see, MRI is an effective means to analyze cirrhosis in patients, whether in the early or late stages. You just need to consider the previously mentioned tips and ensure you have the necessary medical professionals and equipment to make this all possible. Look into upgrading your current medical imaging systems and maintaining them for convenient use.
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