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Technology Insight: advances in liver imaging

Nature Clinical Practice Gastroenterology & Hepatology volume 4, pages 215–228 (2007)Cite this article

Abstract

The role of diagnostic imaging in the assessment of liver disease continues to gain in importance. The classic techniques used for liver imaging are ultrasonography, CT and MRI. In the past decade, there have been significant advances in all three techniques. In this article, we discuss the advances in ultrasonography, CT and MRI that have improved assessment of focal and diffuse liver disease, including the development of hardware, software, processing algorithms and procedural innovations.

Key Points

  • The accuracy of ultrasonography, CT and MRI for the detection and characterization of focal and diffuse liver disease has been markedly improved by technical innovations in the past decade

  • Improvements in gray-scale ultrasonography (such as tissue harmonic imaging) and the introduction of contrast ultrasonography have been the technical mainstay of advances in this field

  • The major development for CT has been the introduction of multidetector helical technology—a prerequisite for fast acquisition of high-resolution images that also provides the option for high-quality image reformations in arbitrary planes

  • Advances in MRI have been even more significant than those in ultrasonography and CT, and include the introduction of rapid, high-resolution imaging, the adoption of magnetic resonance spectroscopy and diffusion-weighted imaging, as well as the development of cell-specific contrast agents

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Figure 1: Tissue harmonic imaging of the liver
Figure 2: Contrast ultrasonography images of focal nodular hyperplasia
Figure 3: Contrast ultrasonography images of liver metastases derived from a gastrinoma in the pancreatic tail
Figure 4: Multiphase imaging scans obtained with axial multidetector helical CT in a patient with alcoholic cirrhosis
Figure 5: Multidetector helical CT can be used to assess hepatic arterial vasculature, as in these maximum-intensity projections of contrast-enhanced images in the arterial phase
Figure 6: Multidetector helical CT and chemical-shift MRI scans from a patient with elevated liver enzyme and bilirubin concentrations
Figure 7: Setup for respiratory triggering, using a navigator sequence
Figure 8: MRI scan that shows hemosiderosis in a patient with plasmocytoma

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Authors and Affiliations

  1. and S Feuerbach is Head of the Department of Radiology, K Schlottmann is Assistant Professor in the Department of Internal Medicine 1, OW Hamer is Assistant Professor, University Hospital of Regensburg, Germany.,

    Okka W Hamer, Klaus Schlottmann & Stefan Feuerbach

  2. CB Sirlin is Assistant Professor in the Department of Radiology, Section of Body Imaging, University of California San Diego Medical Center, San Diego, CA, USA.,

    Claude B Sirlin

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  1. Okka W Hamer
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  2. Klaus Schlottmann
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Correspondence to Okka W Hamer.

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Hamer, O., Schlottmann, K., Sirlin, C. et al. Technology Insight: advances in liver imaging. Nat Rev Gastroenterol Hepatol 4, 215–228 (2007). https://doi.org/10.1038/ncpgasthep0766

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