Modern MR imaging evaluation of the liver includes a comprehensive morphologic and functional assessment of the liver parenchyma, hepatic vessels, and biliary tree and thus aids in the diagnosis of both focal and diffuse liver diseases.

Diffusion-weighted imaging (DWI) provides useful and additional information for the evaluation of the liver, in the identification and characterization of both focal and diffuse diseases, and should be integrated into routine MR imaging protocol.

MR elastography (MRE) is a promising and emerging technique that has become widely accepted for the evaluation of liver fibrosis. Potential indications that are undergoing active research include evaluation of inflammation (hepatitis), differentiation between benign and malignant focal liver lesions, and assessment of portal hypertension.

MR imaging is an accurate and reproducible noninvasive technique for the quantification of liver fat and iron deposition and may limit the use of liver biopsy in the diagnosis and follow-up of patients with steatosis and iron overload.

Newer combined contrast agents combine the extracellular properties of traditional contrast agents with hepatobiliary-specific information and have become a key component of the standard work-up of focal liver lesions. Understanding of their unique pharmacologic properties and the MR imaging technique is fundamental, however, to achieve optimal performance. There is also a potential role for the use of these contrast agents in the anatomic and functional evaluation of the liver.