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MRI of the Abdomen

Basics: What is an MRI of the Abdomen?

An MRI of the Abdomen obtains high-resolution images of the contents of the abdomen, including the liver, spleen, adrenal glands, pancreas, kidneys, G.I. Tract, and supporting mesentery. It is usually obtained with and without contrast. (IV required)

When imaging the Chest, CT (Cat Scan) is the most accurate study in general, whether it is to visualize the lungs, or heart. However, besides the chest, A current ultra high field (3 Tesla) MRI exam is the most accurate exam for the remainder of the body including the Head, Neck, Abdomen, Pelvis, and extremities, which includes the shoulders, hips, knees, ankles, wrists, feet, and breasts.

Discussion of images above:

Above is an excellent example of why MRI has become the gold standard in imaging of the abdomen and pelvis. This study took 20 minutes to complete, and demonstrates multiple abnormalities, including a benign tumor in the liver (hemangioma), multiple cysts in the spleen, and cysts in the liver.

Then why do we order mammography for the breasts? Cat Scan for the abdomen and pelvis? X-rays of the chest, bones, and abdomen? Nuclear medicine studies of the skeletal system?

Of course, the above questions, and discussions that follow these questions are quite complex, and out of the scope of an introductory page on MRI of the abdomen. However, here is a summary of some of the important deciding factors for which test is ordered:

1. Cost. Many screening tests, such as mammography, and Chest x-rays, are inexpensive and are a fairly good screening tool. Although MRI of the breasts is much more accurate, it is also more expensive. CT of the Chest is more accurate, it is also more expensive. When there are indications that an individual has a serious problem with respect to the chest and breasts, and a closer look is required, these more expensive studies are obtained.
2. Your Physician’s perception of which test would be the best. Most of the time, your internist or specialist has a pretty good idea on which test is the most appropriate. However, many times, a physician will call us & talk to us about their patient and ask our advice about which test to order. Imaging has changed so rapidly in the last 10 years, that physicians often aren’t sure which test is best. With respect to imaging the abdomen and pelvis, MRI has clearly become the most accurate test. It is also safer, in that there are no potentially harmful x-rays. It costs a little bit more than CT, but not much. However, until a few years ago, CT was the better study to order, because abdominal (body) MRI images were blurry because the older MRI machines couldn’t acquire the images fast enough. So most practicing physicians have been ordering CT of the abdomen and pelvis for a number of years because that’s what they were taught was the best study. CT is still an excellent study of the abdomen & pelvis. It is still probably the better choice for a patient who can’t lie still for 30 – 45 minutes in an MRI machine. In addition, it is probably as good and sometimes better when looking at problems with the GI tract (small bowel and colon). MRI is clearly better for the best soft tissue definition of solid organs such as the spleen, liver, kidneys, adrenal glands, and pancreas. It can take pictures of the gallbladder and biliary system in a way that CT cannot. Many times, patients get CT scans, and they are referred for an MRI scan in addition to help answer more complex problems that CT cannot answer alone. So again, there is no simple explanation for which test is best.
3. Insurance. Often the determining factor is which study the insurance company will authorize.

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