Magnetic Resonance Imaging
Donald G. Mitchell
Thomas Jefferson University Hospital, Philadelphia, PA, USA
Search for more papers by this authorDonald G. Mitchell
Thomas Jefferson University Hospital, Philadelphia, PA, USA
Search for more papers by this authorDaniel K. Podolsky MD
President, University of Texas Southwestern Medical Center, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorMichael Camilleri MD
Executive Dean for Development, Atherton and Winifred W. Bean Professor, Professor of Medicine, Physiology and Pharmacology, Distinguished Investigator, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorJ. Gregory Fitz MD FAASLD
Executive Vice President for Academic Aff airs and Provost, University of Texas Southwestern Medical Center, Dean, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorAnthony N. Kalloo MD
Professor of Medicine, Johns Hopkins University School of Medicine, Director, Division of Gastroenterology & Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorFergus Shanahan MD
Professor and Chair, Department of Medicine, Director, Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland
Search for more papers by this authorTimothy C. Wang MD
Chief, Division of Digestive and Liver Diseases, Silberberg Professor of Medicine, Department of Medicine and Irving Cancer Research Center, Columbia University Medical Center, New York, NY, USA
Search for more papers by this authorSummary
This chapter explains some of the tissue characteristics and basic principles of imaging and discusses specific applications and techniques in magnetic resonance imaging (MRI). A magnetic resonance technique that simulates magnetic resonance angiography (MRA) but which differs in principle is magnetic resonance cholangiopancreatography (MRCP). The goal of MRCP is to selectively image fluid within the biliary tree and pancreatic duct. Various comparisons of contrast-enhanced computed tomography (CT) and MRI have shown that MRI has significantly better capacity to characterize liver lesions. MRI of the pancreas is optimally performed with a high-performance gradient system (1.5 T) using phased-array torso coil to improve the signal-to-noise ratio with a smaller field of view and thin-slice profile. Magnetic resonance sequences used to evaluate the gallbladder are similar to other imaging protocols used in the abdomen, including axial T1-weighted breath-hold gradient echo (GRE) chemical shift sequences, T2-weighted sequences, MRCP, and contrast-enhanced T1-weighted sequences.
References
- Athanasakos A., Mazioti A., Economoulos N., et al. Inflammatory bowel disease – the role of cross sectional imaging techniques in the investigation of small bowel. Insights Imaging 2015; 6: 73.
- Hope T.A., Ohliger M.A., Qayyum A. MR imaging of diffuse liver disease: from technique to diagnosis. Radiol Clin North Am 2014; 52: 709.
- O'Neill E., Hammond N., Miller F.H. MR imaging of the pancreas. Radiol Clin North Am 2014; 52: 757.
- Pickhardt P.J. Recent developments in colorectal imaging. Curr Opin Gastroenterol 2015; 31: 76.
- Roth C.G., Mitchell D.G. Hepatocellular carcinoma and other hepatic malignancies: MR imaging. Radiol Clin North Am 2014; 52: 683.
- Daftari Besheli L, Aran S, Shaqdan K, et al. Current status of nephrogenic systemic fibrosis. Clin Radiol 2014; 69: 661.
- Thomsen HS, Morcos SK, Almen T, et al. Nephrogenic systemic fibrosis and gadolinium-based contrast media: updated ESUR Contrast Medium Safety Committee guidelines. Eur Radiol 2013; 23: 307.
- Manikkavasakar S, AlObaidy M, Busireddy KK, et al. Magnetic resonance imaging of pancreatitis: an update. World J Gastroenterol 2014; 20: 14760.
- DiMagno MJ, Dimagno EP. Chronic pancreatitis. Curr Opin Gastroenterol 2006; 22: 487.
- O'Neill EK, Cogley JR, Miller FH. The ins and outs of liver imaging. Clin Liver Dis 2015; 19: 99.
- Siegelman ES, Chauhan A. MR characterization of focal liver lesions: pearls and pitfalls. Magn Reson Imaging Clin N Am 2014; 22: 295.
- Cogley JR, Miller FH. MR imaging of benign focal liver lesions. Radiol Clin North Am 2014; 52: 657.
- Nagano Y, Matsuo K, Gorai K, et al. Bile duct hamartomas (von Mayenburg complexes) mimicking liver metastases from bile duct cancer: MRC findings. World J Gastroenterol 2006; 12: 1321.
- Garcia-Eulate R, Hussain N, Heller T, et al. CT and MRI of hepatic abscess in patients with chronic granulomatous disease. AJR Am J Roentgenol 2006; 187: 482.
- Nakagawara M, Hanai H, Kajimura M. Images in clinical medicine. Detection of liver abscesses by T1-weighted magnetic resonance imaging. N Engl J Med 2004; 351: 1013.
- Kim YK, Kim CS, Lee JM, et al. Solid organizing hepatic abscesses mimic hepatic tumor: multiphasic computed tomography and magnetic resonance imaging findings with histopathologic correlation. J Comput Assist Tomogr 2006; 30: 189.
- Choi BY, Nguyen MH. The diagnosis and management of benign hepatic tumors. J Clin Gastroenterol 2005; 39: 401.
- Kim YH, Saini S, Blake MA, et al. Distinguishing hepatic metastases from hemangiomas: qualitative and quantitative diagnostic performance through dual echo respiratory-triggered fast spin echo magnetic resonance imaging. J Comput Assist Tomogr 2005; 29: 571.
- Mathieu D, Caseiro-Alves F. Imaging of benign liver lesions. JBR-BTR 2004; 87: 76.
- Motohara T, Semelka RC, Nagase L. MR imaging of benign hepatic tumors. Magn Reson Imaging Clin North Am 2002; 10: 1.
- Yu JS, Rofsky NM. Hepatic metastases: perilesional enhancement on dynamic MRI. AJR Am J Roentgenol 2006; 186: 1051.
- Finley AC, Hosey JR, Noone TC, et al. Multiple focal nodular hyperplasia syndrome: diagnosis with dynamic, gadolinium-enhanced MRI. Magn Reson Imaging 2005; 23: 511.
- Saba L, di Martino M, de Cecco CN, et al. Diagnostic confidence of computed tomography and magnetic resonance in focal liver pathology. Eur J Gastroenterol Hepatol 2015; 27: 97.
- Grazioli L, Morana G, Kirchin MA, et al. Accurate differentiation of focal nodular hyperplasia from hepatic adenoma at gadobenate dimeglumine-enhanced MR imaging: prospective study. Radiology 2005; 236: 166.
- Donati F, Boraschi P, Gigoni R, et al. Focal nodular hyperplasia of the liver: diffusion and perfusion MRI characteristics. Magn Reson Imaging 2013; 31: 10.
- Prasad SR, Wang H, Rosas H, et al. Fat-containing lesions of the liver: radiologic–pathologic correlation. Radiographics 2005; 25: 321.
- Kebapci M, Kaya T, Aslan O, et al. Hepatic adenomatosis: gadolinium-enhanced dynamic MR findings. Abdom Imaging 2001; 26: 264.
- Lee YJ, Lee JM, Lee JS, et al. Hepatocellular carcinoma: diagnostic performance of multidetector CT and MR imaging-A systematic review and meta-analysis. Radiology 2015; 275: 97.
- Digumarthy SR, Sahani DV, Saini S. MRI in detection of hepatocellular carcinoma (HCC). Cancer Imaging 2005; 5: 20.
- Kim YK, Kwak HS, Kim CS, et al. Hepatocellular carcinoma in patients with chronic liver disease: comparison of SPIO-enhanced MR imaging and 16-detector row CT. Radiology 2006; 238: 531.
- Dietrich CF, Kratzer W, Strobe D, et al. Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI. World J Gastroenterol 2006; 12: 1699.
- Petralia G, Padhani A, Summers P, et al. Whole-body diffusion-weighted imaging: is it all we need for detecting metastases in melanoma patients? Eur Radiol 2013; 23: 3466.
- Kanematsu M, Goshima S, Kondo H, et al. Reply: How far do we need to elaborate the quality of diffusion-weighted MR images of the liver? Abdom Imaging 2013; 38: 1183.
- Akay S, Kocaoglu M, Emer O, et al. Diagnostic accuracy of whole-body diffusion-weighted magnetic resonance imaging with 3.0 T in detection of primary and metastatic neoplasms. J Med Imaging Radiat Oncol 2013; 57: 274.
- Dajbog E, Lefter LP, Scripcariu V, et al. Diagnostic features of benign pancreatic insulinomas. An analysis of three cases. J Gastrointest Liver Dis 2006; 15: 61.
- Hanninen EL, Pech M, Jonas S, et al. Magnetic resonance imaging including magnetic resonance cholangiopancreatography for tumor localization and therapy planning in malignant hilar obstructions. Acta Radiol 2005; 46: 462.
- Braga L, Semelka RC. Magnetic resonance imaging features of focal liver lesions after intervention. Top Magn Reson Imaging 2005; 16: 99.
- Braga L, Semelka RC, Pietrobon R, et al. Does hypervascularity of liver metastases as detected on MRI predict disease progression in breast cancer patients? AJR Am J Roentgenol 2004; 182: 1207.
- Kim SK, Lim HK, Kim YH, et al. Hepatocellular carcinoma treated with radio-frequency ablation: spectrum of imaging findings 1. Radiographics 2003; 23: 107.
- Kierans AS, Elazzazi M, Braga L, et al. Thermoablative treatments for malignant liver lesions: 10-year experience of MRI appearances of treatment response. AJR Am J Roentgenol 2010; 194: 523.
- Danrad R, Martin DR. MR imaging of diffuse liver diseases. Magn Reson Imaging Clin North Am 2005; 13: 277, vi.
- Hussain HK, Chenevert TL, Londy FJ, et al. Hepatic fat fraction: MR imaging for quantitative measurement and display. Early experience. Radiology 2005; 237: 1048.
- Pilleul F, Chave G, Dumortier J, et al. Fatty infiltration of the liver. Detection and grading using dual T1 gradient echo sequences on clinical MR system. Gastroenterol Clin Biol 2005; 29: 1143.
- Chiang HJ, Lin LH, Li CW, et al. Magnetic resonance fat quantification in living donor liver transplantation. Transplant Proc 2014; 46: 666.
- Qayyum A, Goh JS, Kakar S, et al. Accuracy of liver fat quantification at MR imaging: comparison of out-of-phase gradient-echo and fat-saturated fast spin-echo techniques. Initial experience. Radiology 2005; 237: 507.
- Balassy C, Feier D, Peck-Radosavljevic M, et al. Susceptibility-weighted MR imaging in the grading of liver fibrosis: a feasibility study. Radiology 2014; 270: 149.
- Virtanen JM, Pudas TK, Ratilainen JA, et al. Iron overload: accuracy of in-phase and out-of-phase MRI as a quick method to evaluate liver iron load in haematological malignancies and chronic liver disease. Br J Radiol 2012; 85: e162.
- Alustiza JM, Artetxe J, Castiella A, et al. MR quantification of hepatic iron concentration. Radiology 2004; 230: 479.
- Wood JC, Enriquez C, Ghugre N, et al. MRI R2 and R2* mapping accurately estimates hepatic iron concentration in transfusion-dependent thalassemia and sickle cell disease patients. Blood 2005; 106: 1460.
- Gandon Y, Olivie D, Guyader D, et al. Non-invasive assessment of hepatic iron stores by MRI. Lancet 2004; 363: 357.
- Bilaj F, Hyslop WB, Rivero H, et al. MR imaging findings in autoimmune hepatitis: correlation with clinical staging. Radiology 2005; 236: 896.
- Martin DR, Seibert D, Yang M, et al. Reversible heterogeneous arterial phase liver perfusion associated with transient acute hepatitis: findings on gadolinium-enhanced MRI. J Magn Reson Imaging 2004; 20: 838.
- Martin DR, Semelka RC. Magnetic resonance imaging of the liver: review of techniques and approach to common diseases. Semin Ultrasound CT MR 2005; 26: 116.
- Koinuma M, Ohashi I, Hanafusa K, et al. Apparent diffusion coefficient measurements with diffusion-weighted magnetic resonance imaging for evaluation of hepatic fibrosis. J Magn Reson Imaging 2005; 22: 80.
- Inoue T, Kudo M, Watai R, et al. Differential diagnosis of nodular lesions in cirrhotic liver by post-vascular phase contrast-enhanced US with Levovist: comparison with superparamagnetic iron oxide magnetic resonance images. J Gastroenterol 2005; 40: 1139.
- Hennedige TP, Neo WT, Venkatesh SK. Imaging of malignancies of the biliary tract-an update. Cancer Imaging 2014; 14: 14.
- Patel T. Cholangiocarcinoma. Nat Clin Pract Gastroenterol Hepatol 2006; 3: 33.
- Singh P, Patel T. Advances in the diagnosis, evaluation and management of cholangiocarcinoma. Curr Opin Gastroenterol 2006; 22: 294.
- O'Regan DP, Fitzgerald J, Allsop J, et al. A comparison of MR cholangiopancreatography at 1.5 and 3.0 Tesla. Br J Radiol 2005; 78: 894.
- Kamisawa T, Tu Y, Egawa N, et al. MRCP of congenital pancreaticobiliary malformation. Abdom Imaging 2007; 32: 129.
- Şurlin V, Săftoiu A, Dumitrescu D. Imaging tests for accurate diagnosis of acute biliary pancreatitis. World J Gastroenterol 2014; 20: 16544.
- Tamura R, Ishibashi T, Takahashi S. Chronic pancreatitis: MRCP versus ERCP for quantitative caliber measurement and qualitative evaluation. Radiology 2006; 238: 920.
- Morera FJ. Magnetic resonance cholangiography in gallstone pancreatitis. Ann Surg 2006; 244: 159.
- Lee NJ, Kim KW, Kim TK, et al. Secretin-stimulated MRCP. Abdom Imaging 2006; 31: 575.
- Ichikawa T, Sou H, Araki T, et al. Duct Penetrating Sign at MRCP: usefulness of differentiating inflammatory pancreatic mass from pancreatic carcinoma. Radiology 2001; 221: 107.
- Gillams AR, Kurzawinski T, Lees WR. Diagnosis of duct disruption and assessment of pancreatic leak with dynamic secretin-stimulated MR cholangiopancreatography. AJR Am J Roentgenol 2006; 186: 499.
- Sandrasegaran K, Nutakki K, Tahir B, et al. Use of diffusion-weighted MRI to differentiate chronic pancreatitis from pancreatic cancer. AJR Am J Roentgenol 2013; 201: 1002.
- Park HS, Lee JM, Choi HK, et al. Preoperative evaluation of pancreatic cancer: comparison of gadolinium-enhanced dynamic MRI with MR cholangiopancreatography versus MDCT. J Magn Reson Imaging 2009; 30: 586.
- O'Neill E, Hammond N, Miller FH. MR imaging of the pancreas. Radiol Clin North Am 2014; 52: 757.
- Romijn MG, Stoker J, van Eijck CH, et al. MRI with mangafodipir trisodium in the detection and staging of pancreatic cancer. J Magn Reson Imaging 2000; 12: 261.
- Schima W, Fugger R, Schober E, et al. Diagnosis and staging of pancreatic cancer: comparison of mangafodipir trisodium-enhanced MR imaging and contrast-enhanced helical hydro-CT. AJR Am J Roentgenol 2002; 179: 717.
- McAuley G, Delaney H, Colville J, et al. Multimodality preoperative imaging of pancreatic insulinomas. Clin Radiol 2005; 60: 1039.
- Spinelli KS, Fromwiller TE, Daniel RA, et al. Cystic pancreatic neoplasms: observe or operate. Ann Surg 2004; 239: 651.
- Lopez HE, Pech M, Ricke J, et al. Magnetic resonance imaging in the assessment of cystic pancreatic lesions: differentiation of benign and malignant lesion status. Acta Radiol 2006; 47: 121.
- Sand J, Nordback I. The differentiation between pancreatic neoplastic cysts and pancreatic pseudocyst. Scand J Surg 2005; 94: 161.
- Pamuklar E, Semelka RC. MR imaging of the pancreas. Magn Reson Imaging Clin North Am 2005; 13: 313.
- Kim YH, Saini S, Sahani D, et al. Imaging diagnosis of cystic pancreatic lesions: pseudocyst versus nonpseudocyst. Radiographics 2005; 25: 671.
- Sahani DV, Kadavigere R, Blake M, et al. Intraductal papillary mucinous neoplasm of pancreas: multi-detector row CT with 2D curved reformations. Correlation with MRCP. Radiology 2006; 238: 560.
- Takahashi Y, Sakamoto Y, Shimada K, et al. Imaging features of large intraductal papillary mucinous carcinoma of the pancreatic tail. Pancreas 2006; 32: 334.
- Peeters E, Op de Beeck B, Osteaux M. Primary pancreatic and renal non-Hodgkin's lymphoma: CT and MR findings. JBR-BTR 2001; 84: 108.
- Kiresi DA, Kivrak AS, Ecirli S, et al. Secondary breast, pancreatic, and renal involvement with non-Hodgkin's lymphoma: Imaging findings. Breast 2006; 15: 106.
- Elsayes KM, Narra VR, Abou El Abbass HA, et al. Pancreatic tumors: diagnostic patterns by 3D gradient-echo post contrast magnetic resonance imaging with pathologic correlation. Curr Probl Diagn Radiol 2006; 35: 125.
- Oikarinen H. Diagnostic imaging of carcinomas of the gallbladder and the bile ducts. Acta Radiol 2006; 47: 345.
- Jung SE, Lee JM, Lee K, et al. Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern. Eur Radiol 2005; 15: 694.
- Pedrosa I, Guarise A, Goldsmith J, et al. The interrupted rim sign in acute cholecystitis: a method to identify the gangrenous form with MRI. J Magn Reson Imaging 2003; 18: 360.
- Oh KY, Gilfeather M, Kennedy A, et al. Limited abdominal MRI in the evaluation of acute right upper quadrant pain. Abdom Imaging 2003; 28: 643.
- Kaza RK, Gulati M, Wig JD, et al. Evaluation of gallbladder carcinoma with dynamic magnetic resonance imaging and magnetic resonance cholangiopancreatography. Australas Radiol 2006; 50: 212.
- Ascenti G, Visalli C, Genitori A, et al. Multiple hypervascular pancreatic metastases from renal cell carcinoma: dynamic MR and spiral CT in three cases. Clin Imaging 2004; 28: 349.
- Asbach P, Dewey M, Klessen C, et al. Respiratory-triggered MRCP applying parallel acquisition techniques. J Magn Reson Imaging 2006; 24: 1095.
- Kondo S, Isayama H, Akahane M, et al. Detection of common bile duct stones: comparison between endoscopic ultrasonography, magnetic resonance cholangiography, and helical-computed-tomographic cholangiography. Eur J Radiol 2005; 54: 271.
- Schmidt S, Chevallier P, Novellas S, et al. Choledocholithiasis: repetitive thick-slab single-shot projection magnetic resonance cholangiopancreaticography versus endoscopic ultrasonography. Eur Radiol 2007; 17: 241.
- Griffin N, Wastle ML, Dunn WK, et al. Magnetic resonance cholangiopancreatography versus endoscopic retrograde cholangiopancreatography in the diagnosis of choledocholithiasis. Eur J Gastroenterol Hepatol 2003; 15: 809.
- Katabathina VS, Dasyam AK, Dasyam N, et al. Adult bile duct strictures: role of MR imaging and MR cholangiopancreatography in characterization. Radiographics 2014; 34: 565.
- Weber C, Kuhlencordt R, Grotelueschen R, et al. Magnetic resonance cholangiopancreatography in the diagnosis of primary sclerosing cholangitis. Endoscopy 2008; 40: 739.
- Vitellas KM, Keogan MT, Freed KS, et al. Radiologic manifestations of sclerosing cholangitis with emphasis on MR cholangiopancreatography. Radiographics 2000; 20: 959.
- Lee JH, Jang HS, Kim JG, et al. Prediction of pathologic staging with magnetic resonance imaging after preoperative chemoradiotherapy in rectal cancer: pooled analysis of KROG 10-01 and 11-02. Radiother Oncol 2014; 113: 18.
- Arrivé L, El Mouhadi S. MR enterography versus MR enteroclysis. Radiology 2013; 266: 688.
- Sinha R, Rajesh A. MR imaging of the small bowel: is MR enteroclysis the only valid first-line investigation? Radiology 2013; 266: 689.
- Keeling AN, Morrin MM, McKenzie C, et al. Intravenous, contrast-enhanced MR colonography using air as endoluminal contrast agent: impact on colorectal polyp detection. Eur J Radiol 2012; 81: 31.
- Rimola J, Ordás I. MR colonography in inflammatory bowel disease. Magn Reson Imaging Clin N Am 2014; 22: 23.
- Thornton E, Morrin MM, Yee J. Current status of MR colonography. Radiographics 2010; 30: 201.
- Singh K, Singh N, Thukral C, et al. Magnetic resonance imaging (MRI) evaluation of perianal fistulae with surgical correlation. J Clin Diagn Res 2014; 8: RC1.