Diagnostic approach to protocoling and interpreting magnetic resonance studies of the abdomen and pelvis

Respiration and bowel peristalsis are the major artifacts that have lessened the reproducibility of magnetic resonance imaging (MRI). The great majority of diseases can be characterized by defining their appearance on T1, T2, and early and late postgadolinium images. This chapter discusses the combination of these four parameters for the evaluation of abdomino-pelvic disease. The most commonly used GE sequences for routine abdominal imaging are spoiled gradient echo (SGE) and Three-dimensional (3D) gradient echo (GE) sequences. Echo-train spin-echo (ETSE) sequences, and T2-weighted sequences in general, are important for evaluating the liver and pelvis. Gadolinium contrast agent is most effective when it is administered as a rapid bolus, with imaging performed with T1-weighted SGE or 3D-GE sequences obtained in a dynamic serial fashion. MRI is currently considered the most expensive imaging modality, which has hampered its appropriate utilization.