Abdominal and Pelvic MRI

MRI and MRS of the Liver

Normal vs NAFLD SpectThe Liver MR imaging group is investigating the role MR imaging, including diffusion weighted imaging and MR spectroscopy, can play in noninvasive assessment of nonalcoholic fatty liver disease (NAFLD) and in changes in the liver and in metabolism due to diet. In particular, we are looking at assessing grades of steatosis and inflammation and the stage of fibrosis in the liver. We have several ongoing studies that include in vivo MR imaging of patients who are going on for a biopsy. In addition to the in vivo MR data, we have clinical and pathological information on these patients, many of whom are part of the UCSF site of the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN), an NIH, NIDDK funded, multicenter study. We are also obtaining high resolution magic angle spinning (HRMAS) spectroscopy from liver tissue samples to help guide our in vivo efforts. Currently, fatty liver disease is definitively diagnosed and assessed using invasive biopsies. In view of the high population prevalence of NAFLD, a non-invasive mode of distinguishing the relatively benign condition of simple fatty liver (or steatosis) from the more progressive form, Non Alcoholic Steatohepatitis (NASH) would be preferable and very broadly applicable. Our preliminary data shows striking MR differences between normal and diseased patients and among the different grades of steatosis, demonstrating the potential promise of MR for the noninvasive evaluation of fatty liver disease.


  1. Gugliucci A, Lustig RH, Caccavello R, Erkin-Cakmak A, Noworolski SM, Tai VW, Wen MJ, Mulligan K, Schwarz JM. Isocaloric fructose restriction lowers apoC-III levels and yields less atherogenic lipoprotein profiles in children with obesity and metabolic syndrome. Atherosclerosis. 2016. EPub. July 16, 2016. (PMCID: In Process).
  2. Lustig RH, Mulligan K, Noworolski SM, Tai VW, Wen MJ, Erkin-Cakmak A, Gugliucci A, Schwarz JM. Isocaloric fructose restriction and metabolic improvement in obese children with metabolic syndrome. Obesity. 2016 Feb;24(2):453-60. doi: 10.1002/oby.21371. (PMCID: PMC4736733).
  3. Schwarz JM. Noworolski SM, Wen MJ, Dyachenko A, Prior JL, Weinberg ME, Herraiz LA, Bergeron N, Bersot TP, Rao MN, Schambelan M, and Mulligan K. Effect of a High-Fructose Weight-Maintaining Diet on Lipogenesis and Liver Fat. J Clin Endo Metab. 2015 100(6):2434-2442. DOI: http://dx.doi.org/10.1210/jc.2014-3678. (PMCID: PMC4454806).
  4. Eatesam M, Noworolski SM, Tien PC, Nystrom M, Dodge JL, Merriman RB, Qayyum A. Liver Diffusivity in Healthy Volunteers and Patients with Chronic Liver Disease: Comparison of Breath-hold and Free-breathing Techniques. J of Mag Res Im. 35(1):103-109. 2012. (PMID: 22034200).
  5. Qayyum A, Nystrom M, Noworolski SM, Chu P, Mohanty A, Lo C, Merriman R. MRI steatosis grading: Development and Initial Validation of a color mapping system. AJR Am J Roentgenol. 198(3):582-588. 2012. (PMID: 22357996)
  6. Noworolski SM, Lam M, Merriman RB, Ferrell L, Qayyum A. Estimation of Steatosis with MRS and MRI: Validation with Histology is Confounded by Differences in Methodology. Radiology. 264:88-96. 2012.
  7. Ghotb A, Noworolski SM, Madden E, Scherzer R, Qayyum A, Pannell J, Ferrell L, Peters M, Tien PC. Adipose Tissue and Metabolic Factors Associated with Steatosis in HIV/HCV coinfection: Histology versus Magnetic Resonance Spectroscopy.  J Acquir Immune Defic Syndr. 55(2):228-231. 2010.
  8. Schwarz J-M, Noworolski SM, Lee GA, Wen M, Dyachenko A, Prior J, Weinberg M, Herraiz L, Rao M, Schambelan M, Bergeron N, Mulligan K. Effects of short-term feeding with high- versus low- fructose isoenergetic diets on hepaticde novolipogenesis, liver fat content and glucose regulation. Proc of the American Diabetes Association Annual Meeting. Diabetes. 58: S382-S383. 2009.
  9. Noworolski SM, Tien PC, Merriman R. Vigneron DB, Qayyum A. Respiratory Motion-Corrected Proton Magnetic Resonance Spectroscopy of the Liver. Magn Reson Im. 27(4): 570-576. 2009.
  10. Bahl M, Qayyum A, Westphalen AC, Noworolski SM, Chu B, Ferrell L, Tien PC, Bass N, Merriman RB. Liver steatosis: investigation of opposed-phase T1-weighted liver MR signal intensity loss and visceral fat measurement biomarkers. Radiology. 249(1): 160-6. 2008. (PMCID: PMC2657853).
  11. Noworolski SM, Mulligan K, Wen M, Herraiz L, Weinberg M, Lee GA, Schwarz J-M. Short-term Dietary Effects on Liver Lipids Measured with 3T MRS. Proc of the Intn’l Soc of Mag Res in Med. 2699. 2008