Is Abdominal MRI A Better Test For Abdominal Pain?

Abdominal MRI is not necessarily a better test for abdominal pain.   Abdominal MRI is more commonly used to answer more specific questions or further evaluate abnormalities found on other imaging tests like ultrasound and CT of the abdomen.

Why is abdominal MRI used?

Abdominal MRI is a longer test taking up to an hour or longer and uses no radiation.  CT is a much shorter test and uses radiation.   Abdominal MRI has many advantages over CT.   The abdominal MRI is often used to further evaluate abnormalities of the abdominal organs.  Abdominal MRI also lets us see certain structures in the abdomen much better.

Liver lesions

Abdominal MRI let’s us provide a diagnosis for lesions of the abdominal organs.  For example, often ultrasound or CT may show a liver mass.  We can only say that it is not a cyst but not much more in many cases.  The abdominal MRI lets us look at the lesions using many different techniques in one test.  By doing so, we can use all the data to come up with a diagnosis.

Pancreatic lesions

Abdominal MRI is often used to further evaluate pancreatic lesions.  Often we can’t say for sure what they are using only ultrasound and CT.  MRI gives us multiple looks at the lesion using different types of sequences.  This allows us to say with more confidence what the lesion is and what should be done for it.

Kidney and adrenal lesions

Same for kidney lesions.  The MRI lets us look very closely inside the cyst or mass and see whether there are any suspicious features which would make tumor more likely.  Same thing for adrenal lesions.  The adrenal glands sit on top of the kidneys.  MRI can often let us reach a specific diagnosis when we see masses.

Abdominal MRI is better at showing some structures

MRI also lets us see structures that CT does not do a good job showing.    A special MRI called an MRCP of the abdomen shows us the bile ducts and any abnormalities.  Bile ducts drain the bile from the liver and help us digest food.  Bile duct can become blocked by a stone or mass.  MRCP also shows us the pancreatic duct and any abnormalities.

MRI is more common for specific questions

CT is therefore often the starting point for evaluating abdominal complaints.  MRI is used to answer more specific questions and look at structures that CT is not so good at showing us, like the bile ducts.   MRI is therefore a complementary test to CT but not necessarily better.

Disadvantages of abdominal MRI

MRI has some disadvantages as well like being longer, more expensive and not showing certain abnormalities that CT can.   MRI is also more prone to artifacts.  MRI is best when the patient can do consistent breath holds and is not claustrophobic.  MRI requires more cooperation from the patient.