MRI in liver cirrhosis

Liver magnetic resonance imaging (MRI) has seen a massive increase in its use over the last decades. Since its first description in the early 1980s, contrast-enhanced MRI is now the gold standard for the diagnosis of hepatocellular cancer in patients with liver cirrhosis. Techniques like magnetic resonance (MR) elastography and combinations of multiple MR parameters in single scanning protocols are now available and these are opening new possibilities for the assessment of multiple aspects of disease in patients with liver cirrhosis. In this narrative review, we provide an overview of the use of MRI in patients with cirrhosis for the diagnosis of and screening for liver cancer, for the diagnosis of cirrhosis and prediction of long-term outcomes, and for the evaluation of portal hypertension. With the multitude of techniques now available and the number of cirrhosis aspects that can be assessed by single scans make the study and application of MRI an attractive target in the search for a technique for use in this group of patients that often have to attend for multiple appointments and multiple tests, including invasive investigations.