MR Elastography of Liver with Iron Overload: Development, Evaluation and Preliminary Clinical Experience with Improved Spin Echo and Spin Echo EPI Sequences

Yogesh K. Mariappan¹, Sudhakar K. Venkatesh¹, Kevin J. Glaser¹, Kiaran P. McGee¹, Richard L. Ehman¹

MR Elastography (MRE) is rapidly gaining clinical acceptance for the assessment of hepatic fibrosis. However, the standard gradient echo MRE technique can fail in cases with high iron deposition within the liver due to T₂* signal loss. To address this issue, spin echo and spin echo EPI MRE pulse sequences with short TE values were developed and evaluated in subjects with and without iron overload. These sequences provided shear stiffness values comparable to the standard MRE sequence in unaffected subjects, and in patients with iron overload where the standard sequence failed, the spin echo approaches successfully provided valid shear stiffness maps.