Chronic liver disease is a highly prevalent condition associated with significant morbidity and mortality. There is need for clinicians to stratify chronic liver disease and for researchers to define meaningful study endpoints. Currently this is often reliant on liver biopsy histology, which is known to be a flawed gold standard. There is a need to develop novel, non-invasive techniques for the evaluation of chronic liver disease that are accurate and reliable.
In this thesis I have demonstrated that multiparametric MRI can stage hepatic fibrosis in an unselected cohort with performance comparable to existing non-invasive fibrosis markers. The assessment of fibrosis is however confounded by inflammation. The sensitivity of multiparametric MRI to inflammation allows the differentiation of simple steatosis and NASH but in a non-alcoholic fatty liver disease (NAFLD) cohort, multiparametric MRI fails to predict fibrosis stage. Evaluating NAFLD with magnetic resonance spectroscopy has shown that this technique is feasible and that lipidomic differences can be demonstrated in patients with NAFLD. Exploring the role of multiparametric MRI in primary sclerosing cholangitis (PSC) has demonstrated a characteristic pattern in the distribution of corrected Tl in PSC suggesting that multiparametric MRI may have a role in its diagnosis and evaluation
