Skip to main content

Advertisement

SpringerLink
Log in

MR Imaging of Acute Abdomen and Pelvis

  • Dual Energy CT (S Nicolaou and M Patlas, Section Editors)
  • Published:
Current Radiology Reports Aims and scope Submit manuscript

Abstract

Magnetic resonance imaging (MRI), although not usually the first diagnostic study in assessment of acute abdominal pain, can offer a radiation-free high tissue-contrast resolution alternative to CT. MRI can be particularly useful in assessment of young or pregnant patients, or patients with renal insufficiency precluding administration of intravenous contrast. In this article, we review MRI appearance of a number of acute abdominal and pelvic processes, including hemorrhage and various ischemic, inflammatory, and infectious conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Bhuiya FA, Pitts SR, McCaig LF. Emergency department visits for chest pain and abdominal pain: United States, 1999-2008. NCHS Data Brief. 2010;43:1–8.

    PubMed  Google Scholar 

  2. http://www.cdc.gov/nchs/data/hus/hus14.pdf#082.

  3. Brenner DJ, Hall EJ. Computed tomography—an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277–84.

    Article  CAS  PubMed  Google Scholar 

  4. • Ditkofsky NG, et al. The role of emergency MRI in the setting of acute abdominal pain. Emerg Radiol. 2014;21(6):615–24. This reference is of importance as it highlights the role of MRI in Emergency Department setting.

  5. Jaegere TD, et al. Screening applications for MRI in the detection of upper abdominal disease: comparative study of non-contrast-enhanced single-shot MRI and contrast-enhanced helical CT. Eur Radiol. 1999;9(5):853–61.

    Article  CAS  PubMed  Google Scholar 

  6. Rubin JI, et al. High-field MR imaging of extracranial hematomas. Am J Roentgenol. 1987;148(4):813–7.

    Article  CAS  Google Scholar 

  7. Hahn PF, et al. Intraabdominal hematoma: the concentric-ring sign in MR imaging. Am J Roentgenol. 1987;148(1):115–9.

    Article  CAS  Google Scholar 

  8. Lane MJ, et al. Active arterial contrast extravasation on helical CT of the abdomen, pelvis, and chest. Am J Roentgenol. 1998;171(3):679–85.

    Article  CAS  Google Scholar 

  9. Balci NC, et al. Renal-related perinephric fluid collections: MRI findings. Magn Reson Imaging. 2005;23(5):679–84.

    Article  PubMed  Google Scholar 

  10. Miliadis L, et al. Spontaneous rupture of a large non-parasitic liver cyst: a case report. J Med Case Rep. 2010;4:2.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Tonolini M, Rigiroli F, Bianco R. Symptomatic and complicated nonhereditary developmental liver cysts: cross-sectional imaging findings. Emerg Radiol. 2014;21(3):301–8.

    Article  PubMed  Google Scholar 

  12. Balci NC, et al. Spontaneous retroperitoneal hemorrhage secondary to subcapsular renal hematoma: MRI findings. Magn Reson Imaging. 2001;19(8):1145–8.

    Article  CAS  PubMed  Google Scholar 

  13. Davis JM 3rd, McLaughlin AP. Spontaneous renal hemorrhage due to cyst rupture: CT findings. Am J Roentgenol. 1987;148(4):763–4.

    Article  Google Scholar 

  14. Sahni VA, Mortele KJ. The bloody pancreas: MDCT and MRI features of hypervascular and hemorrhagic pancreatic conditions. Am J Roentgenol. 2009;192(4):923–35.

    Article  Google Scholar 

  15. Kawashima A, et al. Imaging of nontraumatic hemorrhage of the adrenal gland. Radiographics. 1999;19(4):949–63.

    Article  CAS  PubMed  Google Scholar 

  16. Bowen AD, et al. Adrenal hemorrhage after liver transplantation. Radiology. 1990;176(1):85–8.

    Article  CAS  PubMed  Google Scholar 

  17. Boraschi P, Donati F. Complications of orthotopic liver transplantation: imaging findings. Abdom Imaging. 2004;29(2):189–202.

    Article  CAS  PubMed  Google Scholar 

  18. Lee NK, et al. Diffusion-weighted magnetic resonance imaging for non-neoplastic conditions in the hepatobiliary and pancreatic regions: pearls and potential pitfalls in imaging interpretation. Abdom Imaging. 2015;40(3):643–62.

    Article  PubMed  Google Scholar 

  19. Mortele KJ, Segatto E, Ros PR. The infected liver: radiologic-pathologic correlation. Radiographics. 2004;24(4):937–55.

    Article  PubMed  Google Scholar 

  20. Chundru S, et al. MRI of diffuse liver disease: characteristics of acute and chronic diseases. Diagn Interv Radiol. 2014;20(3):200–8.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Bader TR, et al. MR imaging findings of infectious cholangitis. Magn Reson Imaging. 2001;19(6):781–8.

    Article  CAS  PubMed  Google Scholar 

  22. Altun E, et al. Acute cholecystitis: MR findings and differentiation from chronic cholecystitis. Radiology. 2007;244(1):174–83.

    Article  PubMed  Google Scholar 

  23. Kim PN, Outwater EK, Mitchell DG. Mirizzi syndrome: evaluation by MRI imaging. Am J Gastroenterol. 1999;94(9):2546–50.

    Article  CAS  PubMed  Google Scholar 

  24. Baker ME, et al. ACR appropriateness criteria® acute pancreatitis. Ultrasound Q. 2014;30(4):267–73.

    Article  PubMed  Google Scholar 

  25. • Zhao K, et al. Acute pancreatitis: revised Atlanta classification and the role of cross-sectional imaging. Am J Roentgenol. 2015;205(1):32–41. This reference is of importance as it details the role of imaging in the revised Atlantic criteria for acute pancreatitis.

  26. Thoeni RF. The revised Atlanta classification of acute pancreatitis: its importance for the radiologist and its effect on treatment. Radiology. 2012;262(3):751–64.

    Article  PubMed  Google Scholar 

  27. Mortele KJ, et al. A modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome. Am J Roentgenol. 2004;183(5):1261–5.

    Article  Google Scholar 

  28. Balthazar EJ. Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology. 2002;223(3):603–13.

    Article  PubMed  Google Scholar 

  29. Craig WD, Wagner BJ, Travis MD. Pyelonephritis: radiologic-pathologic review. Radiographics. 2008;28(1):255–77 quiz 327–8.

    Article  PubMed  Google Scholar 

  30. Rathod SB, et al. Role of diffusion-weighted MRI in acute pyelonephritis: a prospective study. Acta Radiol. 2015;56(2):244–9.

    Article  PubMed  Google Scholar 

  31. Ricci ZJ, Oh SK, Stein MW, Kaul B, Flusberg M, Chernyak V, Rozenblit AM, Mazzariol FA. Solid organ abdominal ischemia, Part I: clinical features, etiology, imaging findings and management. Clin Imaging. 2016 (in press).

  32. Boll DT, Merkle EM. Diffuse liver disease: strategies for hepatic CT and MR imaging. Radiographics. 2009;29(6):1591–614.

    Article  PubMed  Google Scholar 

  33. Ito K, et al. MR imaging of acquired abnormalities of the spleen. Am J Roentgenol. 1997;168(3):697–702.

    Article  CAS  Google Scholar 

  34. Kanal E, et al. American College of Radiology white paper on MR safety. Am J Roentgenol. 2002;178(6):1335–47.

    Article  Google Scholar 

  35. Kim DH, et al. ACR appropriateness criteria crohn disease. J Am Coll Radiol. 2015;12(10):1048–57.e4. doi:10.1016/j.jacr.2015.07.005.

  36. • Masselli G, Gualdi G. MR imaging of the small bowel. Radiology. 2012;264(2):333–48. This reference is of interest as it details the role of MR imaging in assessment of small bowel.

  37. Low RN, Chen SC, Barone R. Distinguishing benign from malignant bowel obstruction in patients with malignancy: findings at MR imaging. Radiology. 2003;228(1):157–65.

    Article  PubMed  Google Scholar 

  38. Rabushka LS, Kuhlman JE. Pneumatosis intestinalis, Appearance on MR examination. Clin Imaging. 1994;18(4):258–61.

    Article  CAS  PubMed  Google Scholar 

  39. Gilo NB, Amini D, Landy HJ. Appendicitis and cholecystitis in pregnancy. Clin Obstet Gynecol. 2009;52(4):586–96.

    Article  PubMed  Google Scholar 

  40. Longo SA, et al. Gastrointestinal conditions during pregnancy. Clin Colon Rectal Surg. 2010;23(2):80–9.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Oto A, et al. MR imaging in the triage of pregnant patients with acute abdominal and pelvic pain. Abdom Imaging. 2009;34(2):243–50.

    Article  PubMed  Google Scholar 

  42. Incesu L, et al. Acute appendicitis: MR imaging and sonographic correlation. Am J Roentgenol. 1997;168(3):669–74.

    Article  CAS  Google Scholar 

  43. Kastenberg ZJ, et al. Cost-effectiveness of preoperative imaging for appendicitis after indeterminate ultrasonography in the second or third trimester of pregnancy. Obstet Gynecol. 2013;122(4):821–9.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Pedrosa I, et al. MR imaging evaluation of acute appendicitis in pregnancy. Radiology. 2006;238(3):891–9.

    Article  PubMed  Google Scholar 

  45. Oto A, et al. Right-lower-quadrant pain and suspected appendicitis in pregnant women: evaluation with MR imaging–initial experience. Radiology. 2005;234(2):445–51.

    Article  PubMed  Google Scholar 

  46. Oto A, et al. Revisiting MRI for appendix location during pregnancy. Am J Roentgenol. 2006;186(3):883–7.

    Article  Google Scholar 

  47. Singh A, et al. MR imaging of the acute abdomen and pelvis: acute appendicitis and beyond. Radiographics. 2007;27(5):1419–31.

    Article  PubMed  Google Scholar 

  48. Hibbard LT. Adnexal torsion. Am J Obstet Gynecol. 1985;152(4):456–61.

    Article  CAS  PubMed  Google Scholar 

  49. Pedrosa I, et al. MR imaging of acute right lower quadrant pain in pregnant and nonpregnant patients. Radiographics. 2007;27(3):721–43 discussion 743–53.

    Article  PubMed  Google Scholar 

  50. Duigenan S, Oliva E, Lee SI. Ovarian torsion: diagnostic features on CT and MRI with pathologic correlation. Am J Roentgenol. 2012;198(2):W122–31.

    Article  Google Scholar 

  51. Rha SE, et al. CT and MR imaging features of adnexal torsion. Radiographics. 2002;22(2):283–94.

    Article  PubMed  Google Scholar 

  52. Chiou SY, et al. Adnexal torsion: new clinical and imaging observations by sonography, computed tomography, and magnetic resonance imaging. J Ultrasound Med. 2007;26(10):1289–301.

    PubMed  Google Scholar 

  53. Murase E, et al. Uterine leiomyomas: histopathologic features, MR imaging findings, differential diagnosis, and treatment. Radiographics. 1999;19(5):1179–97.

    Article  CAS  PubMed  Google Scholar 

  54. Mittl RL Jr, Yeh IT, Kressel HY. High-signal-intensity rim surrounding uterine leiomyomas on MR images: pathologic correlation. Radiology. 1991;180(1):81–3.

    Article  PubMed  Google Scholar 

  55. Fennessy FM. MRI of Benign Female Pelvis, In: ARRS Categorical Course. 2013.

  56. McCormack WM. Pelvic inflammatory disease. N Engl J Med. 1994;330(2):115–9.

    Article  CAS  PubMed  Google Scholar 

  57. Tukeva TA, et al. MR imaging in pelvic inflammatory disease: comparison with laparoscopy and US. Radiology. 1999;210(1):209–16.

    Article  CAS  PubMed  Google Scholar 

  58. Parker RA 3rd, et al. MR imaging findings of ectopic pregnancy: a pictorial review. Radiographics. 2012;32(5):1445–60 discussion 1460–2.

    Article  PubMed  Google Scholar 

  59. Tamai K, Koyama T, Togashi K. MR features of ectopic pregnancy. Eur Radiol. 2007;17(12):3236–46.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Montefiore Medical Center, 111 E 210th st, Bronx, NY, 10467, USA

    Mariya Kobi, Milana Flusberg & Victoria Chernyak

Authors
  1. Mariya Kobi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Milana Flusberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Victoria Chernyak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Victoria Chernyak.

Ethics declarations

Conflict of Interest

Mariya Kobi, Milana Flusberg, and Victoria Chernyak each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Dual-Energy CT.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kobi, M., Flusberg, M. & Chernyak, V. MR Imaging of Acute Abdomen and Pelvis. Curr Radiol Rep 4, 33 (2016). https://doi.org/10.1007/s40134-016-0160-1

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s40134-016-0160-1

Keywords

Search

Navigation