Abdominal MRI scan

Definition

A magnetic resonance imaging (MRI) scan of the abdomen is a noninvasive method to create detailed pictures of the inside of the belly area.

Unlike x-rays and computed tomographic (CT) scans, which use radiation, MRI uses powerful magnets and radio waves. Signals from the magnetic field bounce off your body and are sent to a computer, where they are turned into images. Different types of tissues send back different signals.

Single MRI images are called slices. The images can be stored on a computer or printed on film. One exam produces dozens or sometimes hundreds of images.

For more information, see: MRI

Alternative Names

Nuclear magnetic resonance - abdomen; NMR - abdomen; Magnetic resonance imaging - abdomen; MRI of the abdomen

How the test is performed

You may be asked to wear a hospital gown or clothing without metal fasteners (such as sweatpants and a t-shirt). Certain types of metal can be dangerous and may cause inaccurate images.

You will lie on your back on a narrow table, which slides into the middle of the MRI machine.

Small devices, called coils, may be placed around the area being studied. These devices help send and receive the radio waves, and improve the quality of the images.

Some exams require a special dye (contrast). The dye is usually given before the test through a vein (IV) in your hand or forearm. The dye helps the radiologist see certain areas more clearly.

During the MRI, the person who operates the machine will watch you from another room. Several sets of images are usually needed, each taking 2 - 15 minutes. Depending on the type of equipment, the exam may take 1 hour or longer.

How to prepare for the test

You may be asked not to eat or drink anything for 4 - 6 hours before the scan.

Before the test, tell the radiologist if you currently undergo dialysis, as this may affect whether you can have IV contrast. If you fear confined spaces (have claustrophobia), tell your doctor before the exam. You may be given a medicine to help you feel sleepy and less anxious, or your doctor may recommend an "open" MRI, in which the machine is not as close to the body.

The strong magnetic fields created during an MRI can interfere with certain implants, particularly pacemakers. Persons with cardiac pacemakers cannot have an MRI and should not enter an MRI area.

You may not be able to have an MRI if you have any of the following metallic objects in your body:

• Brain aneurysm clips
• Certain types of artificial heart valves
• Heart defibrillator or pacemaker
• Inner ear (cochlear) implants
• Recently placed artificial joints
• Certain types of vascular stents

Tell your health care provider if you have one of these devices when scheduling the test, so the exact type of metal can be determined.

Before an MRI, sheet metal workers or any person who may have been exposed to small metal fragments should receive a skull x-ray to check for metal in the eyes.

Because the MRI contains a magnet, metal-containing objects such as pens, pocketknives, and eyeglasses may fly across the room. This can be dangerous, so they are not allowed into the scanner area.

Other metallic objects are also not allowed into the room:

• Items such as jewelry, watches, credit cards, and hearing aids can be damaged.
• Pins, hairpins, metal zippers, and similar metallic items can distort the images.
• Removable dental work should be taken out just before the scan.

How the test will feel

An MRI exam causes no pain. Some people may become anxious inside the scanner. If you have difficulty lying still or are very anxious, you may be given a mild sedative. Excessive movement can blur MRI images and cause errors.

The table may be hard or cold, but you can request a blanket or pillow. The machine produces loud thumping and humming noises when turned on. You can wear ear plugs to help reduce the noise.

An intercom in the room allows you to speak to the person operating the scanner at any time. Some MRI scanners have televisions and special headphones that you can use to help the time pass.

There is no recovery time, unless you need sedation. After an MRI scan, you can resume your normal diet, activity, and medications.

Why the test is performed

An abdominal MRI provides detailed pictures of the belly area from many different views. It is often used to clarify findings from previous x-rays or CT scans.

This test may be used to diagnose or evaluate:

• Cancer and tumors
• Blood flow in the abdomen
• Blood vessels in the abdomen
• The cause of abdominal pain or swelling
• The cause of abnormal blood test results, such as liver or kidney problems
• Lymph nodes in the abdomen

MRI can distinguish tumors from normal tissues and can help the doctor determine the tumor's size, severity, and spread. This is called staging.

MRI is sometimes used to avoid the dangers of angiography, repeated radiation exposure, iodine-related allergic reactions.

Normal Values

What abnormal results mean

The sensitivity of MRI depends, in part, on the experience of the radiologist.

Abdominal MRI may reveal many medical conditions, including:

• Abscess
• Acute tubular necrosis
• Adrenal masses
• Cancer
• Enlarged spleen or liver
• Gallbladder or bile duct problems
• Gallstones, bile duct stones
• Hemangiomas, or others
• Hydronephrosis (kidney swelling from the backflow of urine)
• Kidney infection
• Kidney damage
• Lymphadenopathy (abnormalities of the lymph nodes)
• Obstructed vena cava
• Pancreatic cancer
• Portal vein obstruction (liver)
• Renal arterial obstruction
• Renal vein thrombosis
• Transplant rejection
• Tumor of the gallbladder

Additional conditions under which the test may be performed:

• Abdominal aortic aneurysm
• Acute renal failure
• Adenomyosis
• Atheroembolic renal disease
• Carcinoma of the renal pelvis or ureter
• Chronic renal failure
• Cystinuria
• Hydatidiform mole
• Injury of the kidney and ureter
• Insulinoma
• Islet of Langerhans' tumor
• Medullary cystic disease
• Multiple endocrine neoplasia (MEN) II
• Multiple endocrine neoplasia (MEN) I
• Nephrolithiasis
• Ovarian cancer
• Pheochromocytoma
• Skin lesion of histoplasmosis

What the risks are

MRI uses no ionizing radiation. To date, there have been no documented significant side effects of the magnetic fields and radio waves used on the human body.

The most common type of contrast (dye) used is gadolinium. It is very safe. Allergic reactions to the substance rarely occur. The person operating the machine will monitor your heart rate and breathing.

MRI is usually not recommended for acute trauma situations, because traction and life-support equipment cannot safely enter the scanner area and the exam can take quite a bit of time.

People have been harmed in MRI machines when they did not remove metal objects from their clothes or when metal objects were left in the room by others.

Special considerations

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References

Pickhardt PJ. Diagnostic imaging procedures in gastroenterology. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 135.