Tab. 4.
Indications for abdominal MRI [ACR–SAR–SPR Practice Parameter for the performance of Magnetic Resonance Imaging (MRI) of the abdomen (Excluding the Liver); https://www.acr.org/-/media/ACR/Files/Practice-Parameters/mr-abd.pdf and ACR–SAR–SPR Practice Parameter for the performance of Magnetic Resonance Imaging (MRI) of the liver; https://www.acr.org/-/media/ACR/Files/Practice-Parameters/mr-liver.pdf]
| Liver | Detection of focal hepatic lesions |
| Focal hepatic lesion characterization, e.g. cyst, focal fat, hemangiomas, and vascular malformations, hepatocellular carcinoma (HCC), hepatoblastoma, metastasis, cholangiocarcinoma, focal nodular hyperplasia, and hepatic adenoma | |
| Evaluation for known or suspected metastasis | |
| Evaluation of vascular patency, including Budd-Chiari and portal vein thrombosis | |
| Evaluation of chronic liver disease, such as hemochromatosis, hemosiderosis, or steatosis | |
| Evaluation of cirrhotic liver and HCC surveillance | |
| Clarification of findings from other imaging studies, laboratory abnormalities, or alternative imaging for contraindications to CT scans | |
| Evaluation of infection | |
| Potential liver donor evaluation, liver resection evaluation, liver transplant evaluation, and evaluation of postsurgical complications | |
| Evaluation of tumor response to treatment, e.g. image-guided liver interventions/tumor ablation, chemoembolization, radioembolization, chemotherapy, radiotherapy, or surgery | |
| Evaluation of known or suspected congenital abnormalities | |
| Informing or guiding clinical decision-making and treatment planning | |
| Pancreas | Detection and preoperative assessment of pancreatic neoplasms |
| Characterization of indeterminate lesions and/or unexplained enlargement detected with other imaging modalities | |
| Identification of causes of pancreatic duct obstruction, including calculi, stricture, or mass | |
| Detection and characterization of pancreatic duct anomalies | |
| Evaluation of pancreatic or peripancreatic fluid collections or fistulae | |
| Evaluation of chronic pancreatitis, including assessment of pancreatic exocrine function | |
| Evaluation of complicated acute pancreatitis and associated complications | |
| Postoperative treatment/follow-up after pancreatic surgery | |
| Spleen | Characterization of indeterminate lesions detected with other imaging modalities |
| Detection and characterization of suspected diffuse abnormalities of the spleen | |
| Evaluation of suspected accessory splenic tissue | |
| Kidneys, ureters and retroperitoneum | Detection of renal tumors |
| Characterization of indeterminate lesions detected with other imaging modalities | |
| Preoperative assessment of renal neoplasms to include evaluation of the arterial supply, renal vein, and inferior vena cava | |
| Evaluation of the urinary tract for abnormalities of anatomy or physiology (MR urography) | |
| Postprocedure surveillance after renal tumor ablation or surgical extirpation via partial or complete nephrectomy | |
| Evaluation of ureteral abnormalities | |
| Evaluation of suspected retroperitoneal fibrosis and other benign lesions | |
| Characterization and staging of retroperitoneal malignant neoplasms | |
| Evaluation or follow-up of lymphadenopathy | |
| Surveillance imaging of the upper urinary tract in patients with urothelial carcinoma | |
| Characterization of complex congenital anomalies | |
| Identification of causes of urinary tract obstruction | |
| Adrenal glands | Detection of suspected pheochromocytoma and functioning adrenal adenoma |
| Characterization of indeterminate lesions detected with other imaging modalities | |
| Staging of malignant adrenal neoplasms | |
| Detection and characterization of congenital anomalies | |
| Vascular | Diagnosis and/or assessment of the following vascular abnormalities: |
| 1. Aneurysm of the aorta and major branch vessels; | |
| II. Stenosis or occlusion of the aorta and major branch vessels resulting from atherosclerotic disease, thromboembolic disease, or large vessel vasculitis; | |
| III. Dissection of the aorta; | |
| IV. Vascular malformation and arteriovenous fistula; | |
| V Portal, mesenteric or splenic vein thrombosis; | |
| VI. Inferior vena cava (IVC), pelvic vein, gonadal vein, renal vein or hepatic vein thrombosis | |
| Vascular evaluation in one of the following clinical scenarios: | |
| 1. Lower extremity claudication; | |
| II. Known or suspected renovascular hypertension; | |
| III. Known or suspected chronic mesenteric ischemia; | |
| IV Hemorrhagic hereditary telangiectasia; | |
| V Known or suspected Budd-Chiari syndrome; | |
| VI. Portal hypertension; | |
| VII. Known or suspected gonadal vein reflux | |
| Preprocedure assessment for the following: | |
| 1. Vascular mapping prior to living organ donation a) Liver b) Kidney c) Pancreas d) Combined organ transplant; | |
| II. Assessment of renal vein and IVC patency in the setting of renal malignancy or neoplasm; | |
| III. Vascular mapping prior to placement of or surgery on a transjugular intrahepatic portosystemic shunt (TIPS); | |
| IV Vascular mapping prior to resection of abdominal and pelvic neoplasms; | |
| V Vascular mapping prior to uterine fibroid embolization; | |
| VI. Vascular mapping prior to hepatic bland embolization, chemoembolization, and radioembolization procedures; | |
| VII. Vascular mapping prior to tissue grafting | |
| Postprocedure assessment for the following: | |
| 1. Evaluation of organ transplant vascular anastomoses (hepatic, renal, and pancreatic); | |
| II. Detection of suspected leak following aortic aneurysm surgery or MR-compatible aortic stent graft placement; | |
| III. Evaluation of ovarian artery collateral flow following uterine fibroid embolization | |
| Bile ducts and gallbladder | Detection, staging, and post-treatment follow-up of bile duct and gallbladder cancer |
| Detection of bile duct or gallbladder stones | |
| Evaluation of bile duct dilation and/or narrowing | |
| Evaluation of suspected congenital abnormalities of the gallbladder or bile ducts | |
| Detection and anatomic delineation of bile leaks | |
| Gastrointestinal tract and peritoneum | Preoperative assessment of gastric neoplasms |
| Detection of small bowel neoplasms | |
| Assessment of inflammatory disorders of the small or large bowel and mesentery (including MR enterography); | |
| Assessment of peritoneal adhesive disease | |
| Detection and evaluation of primary and metastatic peritoneal or mesenteric neoplasms | |
| Detection and characterization of intra-abdominal fluid collections, as well as follow-up after percutaneous or surgical drainage | |
| Evaluation and follow-up of lymphadenopathy | |
| Other applications | Imaging follow-up of abnormalities of the abdomen deemed indeterminate on initial MRI and for which surgery is not advised |
| Detection and characterization of extraperitoneal neoplasms other than above | |
| Evaluation of the abdomen as an alternative to computed tomography (CT) when radiation exposure is an overriding concern in susceptible patients, such as pregnant or pediatric patients, or in patients with a contraindication to iodinated contrast agents | |
| Assessment of treatment response to medical therapy of malignant neoplasms of the abdomen | |
| Determining the organ of origin of an indeterminate (benign or malignant) lesion in the abdomen when the origin is not obvious from other imaging modalities | |
| Identification and characterization of vascular malformations | |
| Evaluation of abdominal wall abnormalities not adequately assessed by other imaging modalities | |
| Assessment of traumatic injury of the abdomen when CT is contraindicated |