The role of magnetic resonance elastography in the evaluation of nonalcoholic fatty liver disease.

MRE can also be used in the follow-up of NAFLD patients nonin-vasively. A recent study showed a 15% increase in MRE-LSM is the strongest predictor of progression to advanced fibrosis in patients with NAFLD. [10] Tamaki et al. [7] also proposed that a combination of MRE with FIB-4 score (MEFIB index) can be used for detecting patients with NAFLD and significant fibrosis for enrollment in NASH clinical trials. Beyond that, MRE-LSM is shown to be a significant predictor of the development of cirrhosis as well as baseline LSM is predictive of the development of liver-related events such as decompensation or death. [11] A recent study that evaluated the MEFIB index showed excellent negative predictive value for hepatic decompensation in patients with NAFLD-related cirrhosis. In this study, the investigators also observed that MRE-LSM is associated with hepatic decompensation, hepatocel-lular carcinoma, and death in patients with NAFLD-related cirrhosis. [12] In conclusion, MRE-LSM is a useful tool for the detection and assessment of hepatic fibrosis in patients with NAFLD. MRE-LSM can also be used for the evaluation of disease progression as well as the predic-tion of disease courses in NAFLD patients.