Update: December 2018
Magnetic resonance imaging of the abdominal cavity and retroperitoneal
spaces – the most detailed and reliable method of research
internal organs. Onибольшую значимость MRI имеет в обследовании
- The liver;
- The kidneys;
- Lymph nodes.
Types of diagnosis:
- MRI – general condition;
- with contrast – differential diagnosis
- magnetic resonance angiography (MRA) – aneurysms, vasculitis,
ischemia, arterial stenosis, aortic dissection, preoperative
vascular stenting planning.
To diagnose diseases of the hollow organs (stomach, thin and
large intestine) MRI is not suitable.
If other research methods gave questionable results.
(CT, ultrasound, x-rays, etc.) or their execution is impossible, then
tomography allows differentiation of various states and
- Diagnosis of diseases of the liver and biliary tract;
- Jaundice of any etiology;
- Internal bleeding;
- Unexplained abdominal pain;
- Enlarged liver and spleen of unknown origin;
- Ischemic changes in the tissues;
- Polyps in the gall;
- Gallstone disease and its complications (gallstones
- Kidney stones, sand in the kidneys;
- Pancreatic Diseases (acute and chronic
- Congenital abnormalities of organs or vessels;
- Suspected liver tumor, pancreatic cancer, kidney cancer,
adrenal glands, extraorgan education;
- Differential diagnostics of volumetric formations in internal
organs identified by other research methods;
- Assessment of the condition of the spleen in blood diseases;
- Abdominal trauma;
- Выявление поражение лимфоузлов retroperitoneal space;
- Benign growths – cysts, adenomas, polyps;
- Preoperative preparation;
- Postoperative monitoring or detection of complications;
- Monitoring the effectiveness of treatment.
A survey MRI of the abdominal cavity assesses the structure, size,
location, shape, blood supply to organs located in
Что показывает MRI брюшной полости и retroperitoneal space?
At a review tomography all internal organs are scanned,
located in the abdominal cavity and retroperitoneal. Tomography allows
- the structure of organs, their size and location;
- developmental abnormalities;
- various pathological changes (inflammation, dystrophy,
- benign neoplasms
- primary malignant tumors and metastatic
- circulatory disorders;
- defeat of large vessels (aorta, inferior vena cava);
- stones in the gall bladder and kidneys.
Onиболее рационально использовать MRI в качестве уточняющего
What does MRI show with contrast?
Cysts, hemangiomas, malignant tumors on conventional MRI
The pictures are very similar to each other. Contrasting is applied for
отличия этих объемных formations. According to the features of filling them
Contrast can accurately determine their nature.
MR images are black and white, but their organs look different.
Some of the structures on them are dark gray or even black, others are
brighter, the third – very bright – almost white.
Normally, each organ gives a signal of a certain intensity.
Onпример, здоровая печень на снимках темнее spleen, но светлее
muscle Healthy and abnormal tissues also differ.
When in the conclusion they write that a signal from an organ or its part
hypointense means it appears darker in the picture,
than normal color. Hyperintense signal – gives a bright light
color in the picture. When the color of the hearth is almost the same as
normal – they say that such a signal is isointensive.
How the organs will look in the pictures also depends on the mode
T1-VI, T2-VI, SPIR – what does it mean?
MRI of the internal organs of the abdominal cavity is performed in several
modes: estimate T1-weighted images (T1-VI) and T2
–Weighted images (T2-VI).
On Т1-взвешенных снимках лучше визуализируются старые
hemorrhage, adipose tissue. Spaces filled with fluid
in this mode they look dark.
On Т2- взвешенных снимках, наоборот, лучше видна вода. Fabrics with
high water content looks brighter compared to
the rest. In this mode, the free fluid in the abdominal is clearly visible.
cavities, fluid in the gallbladder and bile ducts, swelling or
any other liquid formations. Blood, bones, air on T2-VI
look dark. Fat in this mode is darker than in T1, but still
quite bright, and sometimes overlaps the signal from other structures,
which prevents accurate diagnosis. To reduce the signal from
adipose tissue using a special mode SPIR or STIR.
Pathological changes in most cases are accompanied
tissue swelling, i.e. an increase in their water content. Therefore, on
In photos, they look bright in T2 mode and dark in
Normally, the liver has a homogeneous (homogeneous) structure and on
MR images show up as a medium signal intensity.
With many diseases, its structure is disturbed and becomes
heterogeneous. These changes are diffuse and focal.
Diffuse changes that capture the entire body
(swelling, inflammation, fatty rebirth, fibrous transformation).
Diffuse changes are accompanied by hepatitis, cirrhosis,
Hepatitis – inflammation of the liver caused by viruses, exposure
Toxic substances and drugs, autoimmune
processes and other MRI signs of hepatitis:
- diffuse increase in signal intensity on T2-VI (due to edema
- hepatomegaly (increase in size).
Cirrhosis – a chronic progressive disease that occurs in
the result of the replacement of the hepatic parenchyma fibrous tissue.
There is a restructuring of the liver, its lobed is disturbed
structure and formed false slices (regeneration nodes). MRI
signs of cirrhosis:
- Increase or decrease in size
- Heterogeneity of structure
- Splenomegaly (enlargement of the spleen),
- Regeneration nodes on T2-VI – hypointensive (dark), and
hyperintensive (light) on T1-VI
- The expansion of the portal vein,
- Free fluid in the abdominal cavity (ascites).
Steatohepatitis is a fatty degeneration of the liver. Develops on the background
alcoholism, with long-term use of certain drugs, with
metabolic disorders, obesity, etc. MRI признаки
- Диффузное увеличение интенсивности сигнала on T1-VI.
This concept implies the presence of one or several
pathological sites. Focal changes include cysts,
hemangiomas, nodular form of hepatocellular cancer, metastasis.
On МР-изображениях очаговые изменения схожи между собой. With
scan they give a hypointense signal on T1-VI (in the form of
dark areas) and hyperintense trait on T2-VI (in the form of
bright foci). For differential diagnosis required
introduction of contrast.
Mr – signs of focal liver changes:
|Adenocarcinoma (hepatocellular carcinoma)||
Normally, the gallbladder has a pear shape with clear
контурами и однородным content. Horizontal size – less
5cm. Wall thickness 1-3 mm. The width of the common bile duct less than 8
Onиболее полное представление о состоянии желчного пузыря дает
non-contrast magnetic resonance cholangiopancreatography.
Mr cholangiography can detect gallstones and
biliary tract, diagnose biliary strictures (narrowing)
ducts, anomalies of their development.
On МР-изображениях свободная желчь имеет гиперинтенсивный
sign, and the stones are displayed as dark spots (defect
Normally the pancreas has clear contours, lobed
structure. On MRI в Т2 режиме она дает гипоинтенсивный сигнал и на
The pictures look darker than the liver. Pancreatic and general
bile ducts are displayed in white (hyperintensive).
MRI поджелудочной железы позволяет diagnose:
- Evaluation of lesions of parenchymal gland tissue that were
detected by ultrasound;
- Acute and chronic pancreatitis if CT scan does not show accurate
- Дифференциация хронического панкреатита и neoplasms;
- Detection of stones within the pancreatic duct;
- Cysts поджелудочной железы, их characteristic;
- Detection of choledocholithiasis (latent cause of acute
- Benign tumors;
- Malignant neoplasms, their stages,
- Detection of endocrine tumors.
Withзнаки острого панкреатита:
- Diffuse decrease in signal intensity in T1 and increase in T2
mode due to swelling of the parenchyma and the surrounding fiber,
- Fluid accumulation in the retroperitoneal space,
- Fat necrosis.
On фоне воспалительных изменений в паренхиме поджелудочной
glands marked areas of necrosis, manifesting hyperintensive
a sign in T1 mode (look like black spots on a gray background
Withзнаки хронического панкреатита:
- Heterogeneous structure железы с участками фиброза и кальциноза,
fatty degeneration, which is manifested in the pictures different
- The presence of multiple cysts.
The greatest value of MRI pancreas is
differential diagnosis of cystic and neoplastic
The pancreas is susceptible to the development of such tumor.
processes like adenocarcinoma and cystadenocarcinoma, insulinoma
(neuroendocrine tumor), lymphoma, metastases.
Signs of pancreatic adenocarcinoma (cancer):
- Peripheral Contrasting around the Hypointensive Center
(in the picture, the tumor looks like a dark hearth, surrounded by bright
- Symptoms of Accompanying Pancreatitis
- Typical location in the head near the common gall
- Expansion of the virsung duct – the main pancreatic duct
- кистозная многокамерная опухоль с узлами и перегородками different
- expansive growth – the tumor does not germinate surrounding tissue, but
pushes them apart.
Инсулинома – опухоль из β-клеток поджелудочной железы,
which produces an excess of the hormone insulin. Main symptom
diseases – marked reduction in blood sugar levels with development
- foci with a diameter of 1.5-2 cm with clear boundaries
- heterogeneous structure
- The expansion of the common bile and Wirsung ducts,
- combination with metastatic lesions of other organs.
Preparation for 2 days: carbohydrate-free diet, drink Espumizan,
women using the test will make sure that there is no pregnancy. Last
food intake 6 hours before the procedure. Do not drink for 4 hours. In half an hour
drink No-shpu, go to the toilet, remove all metal
For details, see Preparing for an MRI of the abdominal cavity and
Kidneys and adrenal glands
MRI of the kidneys allows you to diagnose the following diseases:
- developmental anomalies,
- kidney abscesses,
- polycystic (cysts in the kidney)
- stones in the kidneys,
- inflammatory diseases (pyelonephritis, glomerulonephritis,
- tumor assessment (for example, carcinoma or transitional cell
- evaluation of xanthogranulomatous pyelonephritis,
- evaluation of benign tumors (for example, oncocytoma and
However, the most valuable
differential diagnosis of tumors and cystic formations
MRI can detect tumors less than 2 cm in diameter,
detect lymph node metastases and tumor blood clots in
vessels of the kidney.
Pathology of the adrenal glands is often detected by chance when performing
MRI of the retroperitoneal space. Most often succeeds
- malignant tumors, metastases;
- to assess the causes of hormonal imbalance.
Symptoms of benign adrenal neoplasms:
- round shape
- even contour
- homogeneous structure.
Signs of a malignant tumor of the adrenal glands:
- irregular shape
- contour uneven, blurred,
- heterogeneous structure (there are areas with different
In the study of the spleen, you can identify the following
- Aspleniya – the absence of an organ
- Ectopia spleen – atypical location,
- The presence of an additional lobule.
- Splenomegaly – an increase in the size of the spleen,
- Hepatosplenomegaly – simultaneous enlargement of the liver and
- Hemochromatosis, a disease caused by excessive deposition
in the tissues of iron-containing pigments,
- Cysts – education round shape, clear contours, structure
- Hematomas – accumulation of blood under the capsule or in the parenchyma,
usually occurs after closed injuries of the abdomen. In the first two days
hematoma gives hyperintensive T2-VI and iso-intensive –
on T1-VI. After the second day, the signal is amplified by
- Spleen infarction – necrosis of the splenic tissue due to
circulatory disorders due to thrombosis or embolism. On
MR images look like a hyposensitive area.
- Spleen tumors.
Contraindications for MRI
- Onличие кардиостимулятора и других электронных устройств,
implanted into the body (insulin pump),
- Onличие в организме металлических предметов, способных к
- First trimester of pregnancy
- Body weight over 120 kg
- Diseases in which the patient cannot stay for a long time
- Severe somatic diseases that require constant monitoring
life functions (ALV).
Preparation for the study
Before performing an MRI of the abdominal organs, it requires simple
Within 2 days before the study must adhere
low-carb diet, give up foods that stimulate
increased gas formation in the intestines.
Tomography is performed on an empty stomach. If an examination is scheduled for
Afternoon, light breakfast is allowed, however after
must pass at least 5 hours.
Failure to comply with these recommendations reduces the quality of the survey.
because of arising artifacts that gives the intestines with his
Immediately before scanning, you must remove all
metal objects, leave the phone, watch and
other electronic equipment.