Indications for body MRI Part I. Upper abdomen and renal imaging

Abstract

The lack of ionizing radiation use in MRI makes the high spatial resolution technique very appealing. Also, the easy access to multiplanar imaging and the fact that gadolinium-DTPA is well tolerated and not nephrotoxic makes MRI a robust alternative in the healthy as well as the renal compromised patient. Furthermore, MRI adds advanced possibility for tissue characterization and pathology detection and dynamic imaging can be performed. Specific contrast agents specific to the hepatobiliary or the reticuloendothelial system can help with additional information in problem cases. The role of MRI for different organs is discussed and a review of the literature is given. We concluded that MRI is considered a useful and non-invasive diagnostic tool for the detection of hepatic iron concentration, to correct misdiagnosis (pseudolesions) from US and CT in focal steatosis and to help with focal lesion detection and characterization, in the healthy and especially in the cirrhotic liver, where MRI is superior to CT. Moreover, MRCP is excellent for identifying the presence and the level of biliary obstruction in malignant invasion and is considered in the literature as a non-invasive screening tool for common bile duct stones, appropriately selecting candidates for preoperative ERCP and sparing others the need for an endoscopic procedure with its associated complications. MRI is the first choice modality for adrenal evaluation in contemporary medical imaging. It is a useful examination in renal as well as splenic pathology and best assesses loco-regional staging, i.e. arterial involvement in pancreatic cancer.