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Magnetic Resonance Elastography (MR Elastography)

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What is a MR Elastography?

MR elastography is when magnetic resonance imaging (MRI) and low-frequency vibrations are combined to produce an elastogram (visual map) of body tissues. It is non-invasive and can predict the stiffness of body tissues such as the liver, much like the ability of a surgeon or doctor to detect liver tumours using palpation (feeling the difference and hardness of a tumour using just their hands).

Conventional techniques like x-rays, MRIs, and CT-scans are unable to predict or detect the properties of body tissues the way palpation can. Now, with the development of the MR elastography, these needs have not only been met but exceeded as palpations can only be used on superficial organs unless surgery is involved. MR elastographies can identify the stiffness of all body tissues, without the need for surgery.

How does a MR Elastography work?

An MR elastography works in a similar way to an MRI, it is also conducted concurrently with an MRI. A typical MRI of the liver takes approximately 45 minutes, while the MR elastography portion of it takes only 5 minutes. MRI machines are essentially huge magnets which use magnetic waves to realign the water molecules in your body. Radio waves then cause these water molecules to produce faint signals which then produce the typical cross-sectional images that we associate with MRIs.
  • In the MR elastography portion of the MRI, a special pad is placed on your body above your liver.
  • The pad produces low-frequency vibrations that pass through your liver.
  • The waves are processed by the MRI machine which then produce cross-sectional images.
  • Cross-sectional images are able to show the stiffness of the liver.
  • The more stiffness there is, the more advanced your liver disease is, which means there is more scarring of your liver (liver fibrosis).

Who needs a MR Elastography?

Your gastroenterologist may recommend a MR elastography is you have one or more of the following issues:

  • Known or suspected liver disease

A MR elastography can help identify the severity of your liver disease and gauge how well you are responding to treatment.

How do I prepare for a MRE?

You may be required to refrain from food for 4-6 hours prior to your procedure. You may continue to take your medication and consume water. Since the MRI machine is a large magnet, it is important that you remove the following metallic items:
  • Jewelry
  • Glasses/spectacles
  • Hearing aids
  • Underwire bras
  • Watches
  • Hairclips
  • Dentures

You must inform the MRI technician if you have one more of the following devices in your body:

  • Pacemaker
  • Cochlear implants
  • Metallic joint prosthesis
  • Artificial heart valves
  • Implantable heart defibrillator

What can I expect after MRE procedure?

A MR elastography is an out-patient procedure that takes approximately 45 minutes. You should be able to go home and go about your normal daily activities.
Your gastroenterologist will schedule a follow-up appointment to discuss your results and decide on treatment options.

What are the benefits of a MR Elastography?

  • Non-invasive 
  • Short procedure lasting a total of 45 minutes
  • More comfortable and safer than a traditional liver biopsy
  • Early detection of liver fibrosis 
  • Effective for obese individuals
  • Helps predict risk of some liver complications such as ascites (accumulation of fluid in the abdomen)

What are the possible complications or risks of a MR Elastography?

There are currently no known complications or risks for a MR elastography. However, as MR elastographies are usually done concurrently with an MRI, a contrast dye might be used. MRI contrast dyes are usually very safe as long as caution is used in patients with pre existing kidney problems.

Frequently asked questions

How accurate is a MR elastography?
A MR elastography is about 90% accurate for the detection of advanced liver fibrosis.
Is a MR elastography painful?
No, it is a painless procedure.
Will I have to stay overnight at the hospital?
No, it is an out-procedure, which means you will be able to go home on the same day.

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Gastrointestinal Care
You Can Trust

This article has been medically reviewed by Dr Bhavesh

Dr Bhavesh Kishor Doshi

BMedSci. (Hons), BMBS (Nottingham), MRCP,
CCT Gastroenterology and Internal Medicine (UK)
Dr Bhavesh is a gastroenterologist with over 20 years of experience in advanced endoscopy and pancreatico-biliary care. He has performed over 15,000 endoscopic procedures, served as Endoscopy Director at NUHS, and remains a Visiting Consultant at NUHS and NTFGH, specialising in complex diagnostic and therapeutic endoscopy.

enquiries@gastrohealth.com.sg

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