Abdominal imaging

[mjl1717]

Question. What could you see on an abdominal MRI that that you would not see on abdominal CT?

(I know the CT is good for masses and some inflammation, but not so much obstructions)

Thanks in advance..

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[Law2Doc]

Question. What could you see on an abdominal MRI that that you would not see on abdominal CT?

(I know the CT is good for masses and some inflammation, but not so much obstructions)

Thanks in advance..

I'll take a stab.
As an intern you will order CTs to look for causes of obstructions pretty regularly, not sure why you think it's not good for this. CT is the work horse of the hospital -- you will order thousands of them because they are cheap and quick and often answer your question. But they are cross sectional xray machines, and really can only depict densities. If a mass has the same density as it's surrounding landscape,(eg an isodense liver mass) you are SOL. MRI allows you to better characterize masses and lesions based on the properties of it's molecular components. It also can be used on patients that for kidney reasons can't receive IV contrast. And you can use MR for studies like MRCP that you can't do with CT. So basically on the wards, you'll order a CT, and the radiologist will perhaps tell you that he sees a mass which could be one of many things, and suggest that you should get an MRI to better characterize it. It's less about which is "better", its more about CT being the cheap, quick starting point that may cue you into whether you need an MRI.

 

[OveractiveBrain]

Question. What could you see on an abdominal MRI that that you would not see on abdominal CT?

(I know the CT is good for masses and some inflammation, but not so much obstructions)

Thanks in advance..

CT: Cheap, fast. It is an xray so useful for bleeds and bone. You get indication of soft tissues masses and inflammation with contrast, but its chosen because it is cheap and fast.

MRI: Expensive, long as ****. Soft Tissues. What is in the abdomen? Yeah. Soft Tissues. MRI is better in every way, except that it takes a year and a day, is expensive, requires special technicians, oh... and is prohibitively expensive.

 

[mjl1717]

My two favorite SDNers!!! [L2D and Overactive Brain] Thank you for clearing that up and for the quick responses!

(As far as obstruction I was thinking Gastogaffin study or Barium enema..)

 

[colbgw02]

My two favorite SDNers!!! [L2D and Overactive Brain] Thank you for clearing that up and for the quick responses!

(As far as obstruction I was thinking Gastogaffin study or Barium enema..)

You might think that, but you'd be wrong. As a rule, don't try to tell the radiologist what kind of contrast to use.

The previous answers aren't wrong, per se, as much as they're incomplete. Radiologists train for years to understand when certain studies are useful and when they're not, so answering your original question is more nuanced than you might realize. Regarding the abdomen, there are very few diagnoses that require proceeding directly to MR. Until you understand the subtleness, it's probably best to avoid ordering abdominal MRIs unless recommended by the radiologist.

 

[Rendar5]

From an EM perspective, only case I can think of would be appendicitis in a pregnant patient where your u/s techs aren't good enough to find it. So to re-iterate as a bove, very few indications to make it a first imaging study of the abdomen.

 

[Dirt]

MRCP is by far the most common use of abdominal MR imaging I have seen.

 

[mjl1717]

Thank you again for the quick responses!

 

[CATrtb]

One of the problems with MRI is bowel motion.