RadteraMRI Abdomen / Liver With and Without Contrast + MRCP
MR+ ContrastAbdomen & Pelvis
Indications
- Characterize liver lesion (HCC, mets, hemangioma, FNH, adenoma)
- Cirrhosis screening / LI-RADS
- Biliary obstruction / stones (MRCP)
- Pancreaticobiliary evaluation
- Iron/fat quantification
Patient prep
- NPO ~4-6 hours (reduces bowel motion, improves MRCP, ensures GB distension)
- MRI safety screening
- IV access for contrast
- Body/torso phased-array coil; breath-hold coaching
Contrast
Agentgadolinium-based; extracellular (e.g., gadobutrol) OR hepatobiliary (gadoxetate disodium/Eovist)
RouteIV
DoseExtracellular 0.1 mmol/kg; gadoxetate 0.025 mmol/kg (0.1 mL/kg)
TimingDynamic: arterial (~late arterial via bolus tracking), portal venous (~60-70 s), delayed (~3-5 min); hepatobiliary phase ~20 min with gadoxetate
Technique
- Breath-hold sequences; respiratory triggering for some T2/DWI
- In/opposed-phase T1 GRE (Dixon) for fat/iron and microscopic fat
- Heavily T2 MRCP (thick-slab radial + thin 3D) BEFORE gadoxetate (contrast darkens biliary signal)
- Dynamic fat-sat 3D T1 GRE pre and multiphase post-contrast
Series / Sequences
| # | Series / Sequence | Plane | Weighting / Recon | Thickness | Notes |
|---|---|---|---|---|---|
| 1 | Ax T2 fat-sat (SSFSE/HASTE) | axial | T2 FS | 5-6 mm | Lesions, fluid |
| 2 | Cor T2 (SSFSE) | coronal | T2 | 5-6 mm | Overview, biliary |
| 3 | Ax T1 in/opposed phase (Dixon) | axial | T1 GRE | 4-5 mm | Steatosis, iron, adenoma |
| 4 | Ax DWI/ADC | axial | DWI | 5-6 mm | b=50, 400-500, 800; lesion detection |
| 5 | MRCP thick-slab radial | coronal oblique | Heavy T2 | 20-40 mm slab | Radial projections; before contrast |
| 6 | MRCP 3D respiratory-triggered | coronal | Heavy T2 (3D) | 1-1.5 mm | Thin source + MIP |
| 7 | Ax 3D T1 GRE fat-sat pre | axial | T1 FS | 3-4 mm | Baseline dynamic |
| 8 | Ax 3D T1 dynamic post (arterial/PV/delayed) | axial | T1 FS +C | 3-4 mm | Multiphase; bolus-tracked arterial |
| 9 | Hepatobiliary phase (gadoxetate) | axial | T1 FS +C | 3-4 mm | ~20 min; lesion uptake, biliary excretion |
Key points
- Perform MRCP and any non-fat-sat T2 BEFORE gadoxetate—contrast in bile/excretion obscures MRCP.
- Late arterial phase timing (bolus tracking/test bolus) is critical for HCC hypervascularity (LI-RADS).
- In/opposed phase detects intracellular fat (steatosis, adenoma, AML) and iron.
- Hepatobiliary phase (gadoxetate) aids FNH vs adenoma and small lesion/metastasis detection.
- DWI improves lesion and small metastasis detection.
References
• ACR-SAR-SPR Practice Parameter for MRI of the Abdomen
• ACR LI-RADS CT/MRI Manual
• AJR: Gadoxetate Disodium-Enhanced MRI of the Liver (Part 1) link
• Radiopaedia: Liver MRI protocol / MRCP
• ACR LI-RADS CT/MRI Manual
• AJR: Gadoxetate Disodium-Enhanced MRI of the Liver (Part 1) link
• Radiopaedia: Liver MRI protocol / MRCP
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.