1. MRI Abdomen, Liver
By Dr. Mohamed Samieh

2. A. right lobe of liver
B. left lobe of liver
C. inferior vena cava
D. body of stomach
E. spleen
F. lower lobe of right lung
G. azygos vein
H. thoracic aorta
I. diaphragm

3. L1 A. external oblique
B. right costal carightilage
C. rectus abdominus
D. transverse colon
E. transverse colon
F. ascending colon
G. pancreas - head
H. duodenum - 2nd part
I. inferior vena cava
J. diaphragm
K. psoas major
L. renal pyramid

4. Lower L2/L3
A. inferior vena cava
B. superior mesenteric
C. superior mesenteric
D. abdominal aorta
E. transverse colon
F. duodenum - part 3
G. descending colon
H. quadratus lumborum
I. spinal cord
J. perirenal fat

5. L4-L5
A. rectus abdominus B. left common iliac
C. left iliacus D. left psoas
E. right external oblique F. right internal oblique
G. right transversus abdominus
H. right ileum I. lumbosacral trunk

6. A. rt head of femur
B. rt rectus abdominus
C. sigmoid colon
D. ureter
E. lower sacrum
F. rectum

9. Upper Abdomen/Liver
Patient Preparation
Have the patient go to the toilet before the study
Explain the procedure to the patient
Ask the patient to undress except for underwear
Ask the patient to remove anything containing metal (hearing aids, hairpins, body jewelry, etc.)
Depending on the purpose of the investigation, have the patient drink a contrast solution (e.g., Lumirem, Guerbet S.A., France) 30 minutes before the beginning of the study

10. Positioning — Supine — Body array coil or body coil — Cushion the legs — If necessary offer the patient ear protectors — If necessary have the patient raise his/her arms above his/her head

11. Contraindications Artificial heart valves Brain aneurysm clips
Heart defibrillator or pacemaker
Inner ear (cochlear) implants
Kidney disease or dialysis (you may not be able to receive contrast)
Recently placed artificial joints
Certain types of vascular stents

12. Indications for MRI of the liver include, but are not limited to: Primary Indications: 1. Detection of focal hepatic lesions 2. Lesion characterization, i.e. cyst, focal fat, hemangioma, hepatocellular carcinoma, metastasis, focal nodular hyperplasia, hepatic adenoma 3. Evaluation for known or suspected metastasis 4. Evaluation of vascular patency 5. Evaluation of diffuse liver disease such as hemochromatosis 6. Evaluation of cirrhotic liver 7. Clarification of findings from other imaging studies or laboratory abnormalities Extended Indications: 1. Potential liver donor evaluation 2. Evaluation of tumor response to treatment, e.g., image-guided liver interventions/tumor ablation, chemo embolization, or post-chemotherapy or surgery 3. Evaluation of known or suspected congenital abnormalities

13. Technique 1- Scout - localizer Sagittal plane Coronal plane
Axial plane

14. Sequence 1 axial T2-weighted
Plane:- From the dome of the liver to the aortic bifurcation
Slice thickness: 8mm
Slice gap: 10–20% of slice thickness (!0.8–1.6mm or factor 1.1–1.2)
FOV: 360–400mm (possibly rectangular FOV)
Saturation slab: axial (parallel) superior to the slices for saturation of the vessels and ventral (coronal) for saturation of the subcutaneous fat

15. Sequence 2 axial
T1-weighted, otherwise as sequence 1
0.5 T:
SE, respiratory compensation:
— TR = 500–600
— TE = 10–20
— Flip angle 90°
1.5 and 1.0 T:GRE (FLASH), breat hhold:
— TR = 120–140
— TE = 4
— Flip angle 60° or
1.0 T:
TSE, breath hold:
— TR = 300
— TE = 12; repeat 3 or 4 times until
the complete organ has been imaged

16. Sequence 3 coronal T2-weighted
Plane:- angle the slices parallel to the ascending aorta, slices must be sufficient to the whole liver from the anterior abdominal wall to the posterior abdominal wall, planning must be done with breath hold
— Slice thickness: 8mm
— Slice gap: 0 (3-D) – 20% (TSE) of slice thickness (!0–1.6mm or factor 1.0–1.2)
— FOV: 380–400mm
— Saturation slab: axial superior to the slices for saturation of the blood vessels

17. HASTE is an echo-planar fast spin echo sequence trademarked by Siemens
HASTE is an echo-planar fast spin echo sequence trademarked by Siemens. The expanded acronym fairly completely describes what it entails: Half-Fourier Acquisition Single-shot Turbo spin Echo imaging.