The Role of Radiology in Advancing Detection and Characterization of Liver Diseases: Insights from Ultrasonography and MR Imaging

Abstract

Ultrasonography and magnetic resonance (MR) imaging play crucial roles in detecting, characterizing, and monitoring liver diseases. Dynamic contrast-enhanced ultrasonography enhances focal liver lesion detection and characterization, while dynamic ultrasound elastography assesses liver fibrosis and portal hypertension. Transient elastography is the most validated elastography method for liver fibrosis evaluation. Acoustic radiation force impulse and shear wave elastography offer diagnostic accuracy comparable to transient elastography with additional advantages. Diffusion-weighted MR imaging improves solid liver tumor detection and characterization, with malignant tumors generally exhibiting lower apparent diffusion coefficients than benign lesions. It is valuable for monitoring treatment response, as early diffusion changes correlate with necrosis. Dynamic contrast-enhanced MR imaging, particularly with gadoxetate, improves focal liver lesion detection and characterization. Perfusion alterations detected by dynamic contrast-enhanced MR imaging occur in liver fibrosis and cirrhosis, correlating with disease severity. Quantitative perfusion MR imaging evaluates tumor response to antiangiogenic or local therapies. MR elastography is a reliable, reproducible, and accurate method for detecting and staging liver fibrosis, outperforming transient ultrasound elastography. It may detect early non-alcoholic steatohepatitis and contribute to liver tumor characterization and treatment response assessment. Advances in ultrasonography and MR imaging have significantly enhanced our ability to diagnose and manage liver diseases non-invasively.