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Resources/Protocols

Abdominal MRI protocols

Breath-hold discipline and contrast timing: abdominal MRI punishes sloppy preparation faster than any other region.

Abdominal protocols live or die on two things the radiographer controls completely — respiratory technique and timing. A perfectly parameterised sequence acquired through inconsistent breath-holds is worthless, and a dynamic liver study started a few seconds late misses the phase the diagnosis depends on.

Deep-dive protocol guides

Full step-by-step protocols — positioning, per-sequence planning, parameters, artifacts and a review checklist for each study:

Studies in this region

  • MRCP
  • Liver dynamic
  • Liver elastography
  • Liver fat fraction
  • Upper abdomen
  • KUB
  • MR urography
  • MR enterography
  • Renal angiography
  • Abdominal angiography

Planning

  • Coach breathing before the first sequence: an unrehearsed patient produces inconsistent breath-holds throughout the exam.
  • Keep breath-hold instructions identical between sequences so slice positions correspond across the study.
  • Use respiratory triggering or navigators for sequences too long to hold, and verify the trigger is tracking before committing.
  • Time dynamic contrast phases from the injection, following the protocol's arterial, portal and delayed windows.
  • For MRCP, keep the heavily T2-weighted slab centred on the biliary tree and confirm coverage on the localizer.

Sequences by study

StudyTypical coreWhy
Upper abdomenT2 with and without fat suppression, in/opposed-phase T1, DWIBroad characterisation of solid organs
Liver dynamic3D fat-suppressed T1 pre-contrast and timed post-contrast phasesLesion enhancement pattern over time
MRCPHeavily T2-weighted thick slab and thin-slice 3DFluid-bright biliary and pancreatic ducts
MR urographyHeavily T2-weighted coronal imaging, optionally with excretory contrast phasesCollecting system and ureteric course
EnterographyCoronal and axial T2 with bowel distension, dynamic post-contrastBowel wall inflammation and strictures
Fat fraction / elastographyMulti-echo chemical-shift sequences; elastography add-on hardwareQuantitative liver assessment

Mistakes that cost repeats

  • Inconsistent breath-holds that shift anatomy between sequences and make comparison impossible.
  • Starting a dynamic series late and losing the arterial phase — unrecoverable without repeating the contrast injection.
  • Respiratory triggering left unchecked while the patient breathes irregularly.
  • Insufficient bowel distension in enterography, which mimics or masks wall thickening.

Common questions

Why does breathing technique matter so much in abdominal MRI?
The abdominal organs move centimetres with respiration. Inconsistent breath-holds shift anatomy between sequences, so a lesion seen on one series may not appear at the same position on the next — and motion blur can hide small lesions entirely.
What is MRCP and how does it work?
MR cholangiopancreatography uses very heavily T2-weighted imaging so that static fluid in the bile and pancreatic ducts appears bright while surrounding tissue is dark, producing a duct map without any contrast injection.
Why are liver studies acquired in multiple contrast phases?
Lesions are distinguished by how their enhancement changes over time. Arterial, portal venous and delayed phases each carry different diagnostic information, and a single post-contrast series cannot substitute for them.
What does in-phase and opposed-phase imaging show?
It detects fat within tissue. Signal that drops on the opposed-phase images indicates fat and water within the same voxel — the basis for identifying hepatic steatosis and fat-containing lesions.

Try it in ScanFlo: Acquire an upper-abdomen T2 with a coached breath-hold, then repeat during free breathing. Compare liver edge sharpness and vessel definition — the difference is entirely technique, not parameters.

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