Contrast-enhanced magnetic resonance imaging of the abdomen

The use of intravenous gadolinium chelates in imaging of the abdomen is helpful in the detection and characterization of disease entities. It is well recognized that magnetic resonance (MR) imaging is more sensitive to the presence or absence of gadolinium chelates than computed tomography is to iodine. By exploiting this strength of gadolinium and MR sequences that reduce artifacts, the usefulness of abdominal MR examinations can be maximized. As a nonspecific extracellular contrast agent, the enhancement of gadolinium chelates reflect blood delivery (capillary phase imaging), capillary permeability (interstitial enhancement), and venous drainage (late interstitial/washout enhancement). In general terms, MR evaluation of abdominal organs is benefited by imaging in both capillary and interstitial phases of enhancement since these separate phases reflect different physiological aspects of disease processes. In this review, optimized investigation using intravenous gadolinium chelates is described for diseases of the kidney, gastrointestinal tract, liver, gallbladder, pancreas, spleen, and adrenal glands. The use of newer intravenous and oral contrast agents, particularly relating to the investigation of bowel and liver diseases, is also discussed.