Recently Yashoda Hospitals, in association with Indian Radiological and Imaging Association (IRIA) – AP Chapter, conducted a unique one-day Continuing Medical Education (CME) programme on MRI Abdomen – Update at Hyderabad. In the current era of increasing health awareness, MRI, which is an imaging modality with no radiation exposure, has proven to be one of the best, showing many of abdominal and pelvic abnormalities with great precision and detail. This helps doctors in making a specific diagnosis and giving accurate treatment. Till date, MRI is the only imaging modality that best demonstrates the tiny ductal anatomy in liver and pancreas very precisely thereby helping in making an accurate and pinpoint diagnosis. M Neelam Kachhap talks to Dr R Chandrasekar, COO & Chief of Radiology and Imaging Sciences, Yashoda Hospital, Secunderabad to know more about abdominal MRI
What lesions in the abdominal cavity can be viewed with a higher precision by MRI?
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| Dr R Chandrasekar |
MRI is very good at characterisation of the composition of lesions (blood, fat, etc.), hence finds great use in the evaluation of liver, adrenal and pelvic masses. Certain MR sequences which selectively depict fluid containing tracts such as biliary system (Magnetic Resonance Cholangio Pancreatography- MRCP) and the urinary tract (MR Urography) are useful not only in diagnosis but also in planning surgery.
What pelvic abnormalities can be seen in detail by MRI?
MRI is superior to CT in the evaluation of the uterus and ovaries. Conditions such as congenital mullerian duct anomalies, fibroids, adenomyosis, endometriosis, adnexal cysts and masses are better imaged on MR. It is also useful in local staging of malignancies of the prostate, rectum, urinary bladder, and endometrium. MR Fistulogram provides a good roadmap to the surgeon in patients with perianal fistulas.
Why is the use of MRI restricted in abdominal imaging?
The major drawback of MRI over CT is the long acquisition time. Multiple sequences have to be acquired and most of the sequences require good breath hold by the patient to prevent motion artifacts which is difficult in old and sick patients. Most recent sequences require 1.5 or 3 Tesla MRI where the availability of the equipment and cost restricts the use. One other disadvantage of MRI is its inferior spatial resolution in comparison to CT.
Screening for haepatoma should be done using MRI. Do you agree?
MRI is more sensitive than other imaging modalities in the early detection of dysplastic nodules and hepatocellular carcinoma in cirrhotic liver. Along with serum alpha-fetoprotein, MRI of the liver is useful as a screening modality in patients with cirrhosis and in the early detection of hepatocellular carcinoma.
MRI is a good substitute when contrast CT is contraindicated. Your comments.
Though MRI cannot completely substitute for CECT, it can be useful in many situations due to the inherent soft tissue contrast that it offers. For example, the urinary tract can be imaged with a non-contrast MR Urogram when contrast CT Urogram is contraindicated; focal lesions in the liver which are difficult to detected on non contrast CT can be imaged using MRI.
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