MRI of the abdominal cavity and pelvis

Comprehensive diagnostic approach

When establishing a diagnosis, visualization using MRI of the abdominal cavity or pelvis is part of a broad examination algorithm. For a complete picture of the patient's condition, imaging methods are complemented by laboratory and instrumental tests.

The basic primary diagnostics package includes:

• Blood tests: mandatory testing for the specific tumor marker CA125 (adenogenic cancer antigen).
• Chest: chest CT, PET-CT, or targeted radiography are used to assess this area.
• Mammary glands: the examination is performed in absolutely all female patients without exception.
• Gastrointestinal tract: an endoscopic examination is performed, necessarily including a combination of esophagogastroduodenoscopy and colonoscopy.
• Cytology: smears from the cervical canal and cervix are examined. If free fluid is present in the pleural or abdominal cavity, obtained by aspiration, puncture, or intraoperatively, it is also sent for cytological analysis.

Specifics of abdominal and pelvic MRI

When choosing an imaging method, the anatomical region and the need for soft tissue detail are taken into account. CT or pelvic MRI, as well as abdominal and retroperitoneal ultrasound or CT, are traditionally used to assess the lymph nodes and pelvic organs.

However, the diagnostic value of tomography varies depending on the area of study:

1. Pelvic organs. Magnetic resonance imaging here is the preferred method compared to computed tomography. At the same time, scanning with intravenous contrast is recognized as significantly more informative than native scanning.
2. Abdominal cavity. In the area of the abdomen, kidneys, and retroperitoneal space, MRI often acts as a supplementary tool. It is advisable to use it as an adjunct if the results of a previously performed CT scan are inconclusive.

Diagnosis during pregnancy

In situations where an oncological process is diagnosed or suspected during pregnancy, the imaging protocol is adapted to ensure fetal safety. The main goal of such an examination is the correct assessment of disease spread and precise planning of further treatment tactics.

Features of managing pregnant patients:

• First trimester: comprehensive ultrasound of the abdominal and pelvic organs is the preferred and safest method in early pregnancy.
• Use of MRI: tomography of the abdominal and pelvic organs is permitted for use, but with one strict limitation. Magnetic resonance imaging of absolutely any location in pregnant women is performed without the administration of paramagnetic contrast agents.

What else to study on this topic

• Criteria for assessing pelvic and retroperitoneal lymph nodes
• Comparison of the informativeness of ultrasound and MRI in the first trimester of pregnancy
• Rules for sampling and cytological examination of fluid from the abdominal cavity
• The role of gastrointestinal endoscopic examinations in primary cancer screening
• Application of PET-CT for visualizing chest structures

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.