Liver Surgery

This is the MRI equivalent of a HIDA scan, but with anatomic detail. It requires administration of the contrast agent Eovist, which has biliary excretion. To work well, the bilirubin should be under 3 mg/dL in those patient's with otherwise normal liver function. In cirrhotic patients with compromised liver function, the bilirubin should be under 2 mg/dL.

MRI may be used for detection and characterization of lesions in the cirrhotic level is based on T2 signal, diffusion, and contrast enhancement characteristics. Because there is no ionizing radiation in the exam, many images with different contrasts can be obtained of the cirrhotic liver, thereby increasing the sensitivity and specificity of the exam.

Note that if an exam is specified as a pre-transplant evaluation, reporting will conform to specific UNOS guidelines.

Characterization of liver masses by MRI is aided by the excellent soft tissue contrast of the modality.

Pre-therapeutic MRI can be helpful in procedure planning by giving a detailed 3D assessment of the location of a hepatic tumor. The assessment includes delineation of the lesion with respect to hepatic veins, portal veins, as well as depiction of arterial blood supply.

MRI is highly sensitive for the detection of both hypervascular and hypovascular liver metastases.

MRI may suggest alternative diagnoses or determine extent of cholangiocarcinomas, assessing extent of the tumor within the bile ducts, lobar atrophy, vascular invasion, and metastatic disease. In particular, MRI may be valuable in identifying isolated bile ducts that are not delineated on more invasive studies such as ERCP or percutaneous cholangiography.