MRI in Abdominopelvic Emergencies

Sachin Kumbhar, MD; Manjiri Dighe, MD, FSAR, FSRU


Appl Radiol. 2014;43(6) 

In This Article

Abstract and Introduction


Acute abdominal pain is a common symptom for patients presenting to the emergency department (ED). It could be due to a variety of reasons, with etiologies ranging from innocuous to life threatening. Imaging is often required to confirm the diagnosis and to make sure that only appropriate patients proceed to the operating room. Computed tomography (CT) is the imaging modality of choice in these situations, except when acute cholecystitis is suspected. CT has been shown to have significant effects on patient management, and its cost-effectiveness has been proven.[1]

However, with the rising use of CT, there has been a rising concern about its harmful effects, especially the risk of induced cancers.[2] Magnetic resonance imaging (MRI) does not involve the use of ionizing radiation and has the potential of answering the diagnostic questions inpatients presenting to the ED with acute abdominal pain.

Yet, it is not possible to use MRI in all clinical situations. In this article, we examine the role of MRI in abdominopelvic emergencies and the practical issues involved. We will also discuss specific issues related to MRI, such as allergic reactions to gadolinium chelates, side-effects of gadolinium, nephrogenic systemic fibrosis (NSF), and its use in patients with renal failure and on dialysis. The use of MRI in vulnerable populations like pregnant women and children is also discussed. This is followed by a brief description of the MRI protocol used at our institute and the contraindications to MRI.