Problem-solving with MRI in acute abdominopelvic conditions, part 1: gastrointestinal, hepatobiliary, and pancreatic diseases.

Pankaj Nepal, Michael Wells, Vijayanadh Ojili, Kanika Khandelwal, Neeraj Lalwani, Ashish Khandelwal

Journal: Emergency radiology 2021;28(6):1161-1172

PMID: 34247289

Abstract

The purpose of this article is to review the benefit and added value and advantages of magnetic resonance imaging (MRI) compared with other cross-sectional imaging in patients presenting with abdominopelvic emergencies. During the past decade, there has been increased utilization of MRI in the emergency department with widespread availability of MR scanners, improvement in rapid imaging techniques, and methods to overcome motion-related artifacts. This has benefited patients at higher risk of radiation, particularly children and pregnant women, and patients with contraindications to iodinated contrast including allergy and renal dysfunction. Still the challenges are: on site MR scanner in the emergency department, after-hour services, as well as availability of time slot to rapidly scan emergency patient. MRI has additional advantages over other imaging modalities due to its high contrast resolution, which allows it to better characterize tissue and fluid collections, and may avoid the need for intravenous contrast. Radiologists must be familiar with the role and added value of MRI, spectrum of imaging findings, and problem-oriented modified MR protocols in abdominal and pelvic emergencies. In part 1, we will discuss the utility of MRI in gastrointestinal, hepatobiliary, and pancreatic diseases. In part 2, the authors will focus on the key MR imaging features of female pelvic gynecological diseases, pregnancy related complications, abdominal vascular complications, and renal diseases.

© 2021. American Society of Emergency Radiology.

Address: Department of Radiology, St. Vincent's Medical Center, Bridgeport, CT, USA.; Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.; Department of Radiology, University of Texas Health, San Antonio, TX, USA.; Department of Hospital Internal Medicine, Mayo Clinic, Austin, MN, USA.; Department of Radiology, Virginia Commonwealth University, Richmond, VA, USA.; Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. [email protected].

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