Can gadolinium-enhanced MRI be used for the grading of liver fibrosis and acute hepatitis?

Hepatitis results from a variety of etiologies and chronic hepatitis can lead to hepatic fibrosis and cirrhosis. The diagnosis and grading of liver disease severity depends upon invasive biopsy. Histopathology is based on percutaneously sampled liver tissue for grading of liver interstitial fibrosis and inflammation. There are limitations associated with liver biopsies including complications such as hepatic bleeding. Thus, gadolinium enhanced MRI as a non-invasive imaging technique has been proposed for the evaluation of chronic liver disease and inflammation. Our hypothesis is that: 1) the degree of gadolinium-chelate contrast agent (Gd) accumulation within the liver, assessed on T1 weighted (T1W) 3D gradient echo (3D GRE) interstitial phase images, will correlate with the degree of histologically defined hepatic fibrosis; and 2) the conspicuity of abnormal transient Gd non-uniform enhancement pattern identified on arterial phase T1W 3D GRE images will correlate with the histologically defined degree of hepatic inflammation.