Mri

MRI Atlas of the Abdomen
(a self-guided tutorial)
Jeff Velez HMS3

Eric Chiang, MD
Gillian Lieberman, MD
Goals
The purpose of this atlas is to provide students with;
an outline of the anatomy of the abdomen via MR imaging.

an introduction to how an MR image is created.
a basic understanding of how the manipulation of various
parameters (TR,TE, pulse sequence) of an MR scan yield
desired tissue differentiation.
a list of some basic sequences used in abdominal MR.
By coupling this review of how an MR image is created

and manipulated with a thorough tour of abdominal
anatomy seen through MRI, this tutorial can serve as an
instructive tool in preparing students for their likely future
clinical encounters with abdominal MRI in evaluating and
managing abdominal disease.
Introduction
Magnetic resonance (MR) imaging has been in widespread clinical
use for well over a decade. Its use was primarily localized to the
evaluation of the central nervous system and then more recently,
the musculoskeletal system. Motion during the cardiac cycle ,
respiration, and peristalsis made MR imaging of the thorax and
abdomen a major challenge. MR imaging of the abdomen started
with the evaluation of solid visceral organs such as the liver and
kidney. With technologic developments in MR hardware and
software occurring at a swift and steady pace, MR imaging of the
abdomen is beginning to expand beyond the solid viscera into the
entire abdomen, including the hollow viscus of the GI tract.
Basics of MRI
In order to read and understand an MR image, one must gain a basic
understanding of the principles underlying its production.

MR imaging is based on the naturally occurring magnetic moment that
exists within the nuclei of a hydrogen atom, as well as its ubiquitous
presence in organic tissue. When an external magnetic field is applied to
organic tissue, protons within hydrogen nuclei align themselves in parallel
with this field and also begin to resonate. When a radiofrequency (RF)
pulse is applied to these aligned protons, it provides enough energy to
dislodge (or excite) them from this orientation. However, this is a
temporary phenomenon, and the nuclei relax back into realignment with
the external magnetic field. Upon relaxation, energy is released in the
form of RF waves. This echo is detected and a signal of variable intensity
for a given location is produced.
Tissue contrast is created because different tissues have different
relaxation times. This is attributable to the different microenvironments
surrounding the magnetized nuclei.
4 Key Parameters of MRI

T1
T2
Echo Time (TE)
Repetition Time (TR)
The relaxation times of protons shifting from a
higher to lower energy level, are referred to as T1

and T2 and are tissue specific.
The TE and TR are variables that can be
controlled by an MR scanner operator.
5
T1 and T2
T1 and T2 represent relaxation time constants.

Each tissue has a specific, inherent T1 and T2 value.
For example: fat has a short T1 and T2, whereas fluid has a long T1
and T2.
These values are measured in milliseconds.
T1 the time it takes nuclei in a particular tissue that has been
excited or dislodged from its parallel orientation to return to its
nonexcited state. (The time when about 63% of the original
longitudinal magnetization is reached).
T2 the time it takes nuclei in a particular tissue that has been
excited into a (phase coherent) transverse or perpendicular
orientation to return to its non excited (non phase coherent) state.
(The time when transverse magnitization decreases to 37% of the
original value).
TR and TE
These are two major parameters that can be adjusted (unlike T1
and T2) to create the desired tissue differentiation.

When an MR image is taken, it begins with a magnetic field being
established that is parallel with the bore of the scanner. This field
has a strength on the order of 1-2 Teslas, depending on the
scanner. Once this is established, and protons have aligned with
the field, a sequence of radiofrequency (RF) pulses are
administered. This excites the protons to a higher energy level.
This is then followed by relaxation back into a low energy state.
This relaxation time is constant (T1 and T2). What can be
changed however is the repetition time (TR) or time between
administered RF pulses. What also can be manipulated is the time
that the RF echo is received by the RF detector. This time is
referred to as TE, or echo time.
By adjusting TE and TR, according to a tissues T1 and T2, the
various tissues in a region of interest can be differentiated.
T1 weighted images vs. T2

weighted images
The following 2 slides offer graphs to help explain tissue
contrast on T1 vs. T2 weighted images.

These graphs are depictions of the signal intensity as
function of time for two tissues types (fat and fluid) in an
external magnetic field.
A helpful way to analyze these graphs is to identify which
curve provides the higher signal intensity (red or blue) at
the time point indicated by the dashed vertical line
(detection time). That point represents the tissue that will
appear brighter on the MR image.
Keep in mind that the TR and TE (along with the sequence
of RF pulses) are what we can manipulate, while T1 and T2
are constant and tissue dependent. They are represented
by the degree of line curvature (exponential relationship) on
the graphs to follow.
T1 Weighted Image
T1 Weighted Imageshort TR and TE
Signal Intensity
fat
fluid
TR = repetition time
TE = echo time
TR
In this graph
fat has a
greater signal
intensity than
fluid. Tissues
with short T1
and T2 (fat)
will appear
brighter than
those with
longer T1 and
T2 (fluid).
TE
Although this is a gross oversimplification, when an image is T1 weighted, this means that the
protocol used to scan a patient involves adjusting the TE and TR (shortening their times) in a
manner that will cause tissues with fast T1 and T2 relaxation times (e.g. fat) to appear brighter.
T2 Weighted Image
T2 Weighted Imagelong TR and TE
Signal Intensity
fat
fluid
TR = repetition time
TE = echo time
TR
In this graph
fluid has a
greater signal
intensity than
fat. Tissues
with long T1
and T2 (fluid)
will appear
brighter than
those with
short T1 and
T2 (fat).
TE
On a T2 weighted image the protocol used is one that
will result in tissue with long T1 and T2 (fluid) having a

higher signal intensity. This is illustrated in the following
slides.
This protocol involves using a TR and TE that are

relatively longer than the T1 weighted sequence.
10
Beyond T1 and T2Abdominal MRI

Along with the advancements in MR scanner hardware
technology, developments in the pulse sequences used have

led to the growing role of MRI in abdominal imaging.
The fundamental principle behind these sequences is to
maximize contrast, resolution, speed, and coverage while
keeping motion and noise (relative to signal) at a minimum.
A list of commonly used sequences (acronyms provided) that
capture abdominal anatomy and pathology include: VIBE,
HASTE, STIR, TSE, and GRE sequences.
Although a description of all of these sequences is beyond
the scope of this atlas, a brief discussion of the VIBE
sequence can provide an introduction to the MR parameters
that are manipulated to achieve maximal contrast,
resolution, speed, and coverage.
11
Volumetric Interpolated Breath-hold

Examination (VIBE)
The VIBE Sequence is T1 based (short TR and TE).
It is a complex 3D Fourier transform sequence that allows for
fast acquisition time, thus reducing motion artifact and allowing

for adequate coverage of the abdomen.
In a given amount of time the VIBE sequence can provide
better tissue contrast by utilizing a technique known as fat
saturation.
Given the relatively high resolution and coverage, VIBE
sequences can be reconstructed and used for angiographic
examinations.
The axial, coronal, sagittal, and selected 3D reconstructions of
the abdomen to follow were performed using the VIBE
sequence.
12
Anatomy of the Abdomen

Throughout this atlas, in axial, coronal, sagittal, and oblique 3D planes,
we will highlight;
Liver
Biliary System
Pancreas
Spleen
Gastrointestinal Tract
Kidneys
Retroperitoneum
Peritoneum
13
We have used images from

3 different patients:
Patient A - 32 year old female
MR settings: VIBE sequence, MR abdomen

Planes: Axial, coronal, and sagittal; coronal MRCP image
Patient B - 54 year old female
MR settings: VIBE sequence, MRA abdomen (focused on
celiac/SMA)
Planes: Maximum intensity projection (MIP) 3D reconstruction
Patient C - 27 year old male
MR Settings: VIBE sequence, MRA abdomen (focused on renal
arteries)
Planes: Maximum intensity projection 3D reconstruction
14
Pt A - Axial VIBE
Plate 1
15
Pt A - Axial VIBE
Plate 2
16
Pt A - Axial VIBE - Dome of the Liver

Liver
R.
Ventricle
L.
Ventricle
Aorta
L. Lower
lobe of
lung
Inferior
Vena
Esophagu
Cava
s
R. Lower
lobe of
lung
Azygos v.
Plate 3
17
Pt A - Axial VIBE
Plate 4
18
Pt A - Axial VIBE
Plate 5
19
Pt A - Axial VIBE
Plate 6
20
Pt A - Axial VIBE
Plate 7
21
Pt A - Axial VIBE
Plate 8
22
Pt A - Axial VIBE - Hepatic Veins

L. Lobe of liver
(lateral segment)
Gastric
fundus
L. hepatic v.
L. Lobe of liver
(medial segment)
M. hepatic
v.
Inferior
vena cava
R. lobe of liver
(anterior segment)
R. hepatic v.
Plate 8
Aorta
R. lobe of liver
(posterior
segment)
Azygos v.
Gastroesophageal
junction Hemiazygos v.
L. lower lobe of
lung
Spleen
23
Pt A - Axial VIBE
Plate 9
24
Pt A - Axial VIBE
Plate 10
25
Pt A - Axial VIBE - Hepatic Divisions
M. hepatic
vein
R. hepatic
vein
LLSLateral segment of left lobe
LMSMedial segment of left
lobe
RASAnterior segment of right
lobe
RPSPosterior segment of right
lobe
Plate 10
LM
S
RA
S
LLS
L. hepatic
vein
Inferior vena
cava
RP
S
The superior aspect of the liver serves as a good reference point

when inspecting axial images of the liver. It can be divided into 4
segments based on the alignment of the hepatic veins draining
into the inferior vena cava. The dashed line indicates the
respective course of the three hepatic veins. These segments can
be further divided into superior and inferior segments.
26
Pt A - Axial VIBE
Plate 11
27
Pt A - Axial VIBE
Plate 12
28
Pt A - Axial VIBE - Splenic Hilum
The spleen is an
intraperitoneal structure,
enclosed by peritoneum
except at its hilum where
the splenic vessels enter
and leave. It can be
readily differentiated from
the kidney by its location
adjacent to the
posterolateral chest wall.
Important relationships of
the spleen include
abutment of the posterior
aspect of the stomach as
well as the tail of the
pancreas
Plate 12
Splenic flexure
Posterior aspect of
stomach
Tail of pancreas
Splenic vein
Splenic
artery
Posterior
chest wall
29
Pt A - Axial VIBE
Plate 13
30
Pt A - Axial VIBE
Plate 14
31
Pt A - Axial VIBE - Adrenal Gland and Spleen
Gastric
fundus
L. portal vein
Inferior vena
cava
R. portal vein
Aorta
R. adrenal
gland
R. crus of
diaphragm
Body of pancreas
L. adrenal
gland
Spleen
Ascending
lumbar veins
Spinal
cord
L. crus of
diaphragm
Vertebral
body
Ascending
lumbar
veins
Plate 14
32
Pt A - Axial VIBE
Plate 15
33
Pt A - Axial VIBE - Adrenal Glands
This image illustrates

the characteristic
inverted Y
appearance of the
adrenal glands. The
adrenal glands reside
on the anteromedial
and superior aspect of
the kidneys.
Plate 15
34
Pt A - Axial VIBE
Plate 16
35
Pt A - Axial VIBE
Plate 17
36
Pt A - Axial VIBE - Celiac Trunk

Common hepatic a.
Ligamentum
teres
Celiac Trunk
Gastric body
Hepatic a. fossa
Splenic flexure
Caudate
lobe
Body of
Pancreas
L. adrenal gland
Desc. colon
Spleen
Portal vein
Inferior vena
cava
L. kidney
R. kidney
Aorta
Plate 17
37
Pt A - Axial VIBE
Plate 18
38
Pt A - Axial VIBE
Hepatic artery
Portal vein
Caudate lobe
Inferior vena
cava
R. Adrenal gland
(see plates 2024)
Plate 18
A notable anatomic relationship exists at the level of the

right adrenal gland that involves a posterior to anterior
sequence of structures that line up in a relatively linear
fashion. These include, from posterior to anteriorR.
adrenal gland, IVC, caudate lobe, portal vein, and
hepatic artery.
39
Pt A - Axial VIBE
Plate 19
40
Pt A - Axial VIBE - Body of Pancreas

Gastric
body
Small bowel
Splenic
vein
Pancreatic duct
L. lobe
(lateral) teres
Ligamentum
L. lobe
(medial)
Neck of
gallbladder
Porta
hepatis
Portal
vein
Hepatic
artery
Inferior
vena cava
Plate 19
R.
kidney
Superior mesenteric
artery
Aorta
Body of pancreas
L.
kidney
Descending
colon
Splee
n
41
Pt A - Axial VIBE
Plate 20
42
Pt A - Axial VIBE
Plate 21
43
Pt A - Axial VIBE - Origin of SMA

Gastric body
Small bowel
Descending
colon
Ligamentum teres
Body of
pancreas
Gastric
Hepatic
antrum artery
Neck of gallbladder
Porto-splenic
confluence
Portal vein
Neck of pancreas
Splenic vein
R. kidney
Plate 21
Inferior vena cava

R. renal vein
Superior mesenteric artery
Aorta
L. kidney
44
Pt A - Axial VIBE
Plate 22
45
Pt A - Axial VIBE - Relationships of the

Superior Mesenteric Artery
Body of pancreas
This slide shows another
Splenic vein
important relationship that
exists surrounding the SMA.
There are four structure to
be aware of. These include
the body of the pancreas
and splenic artery, which
pass over the SMA
anteriorly. Posteriorly, the
duodenum and left renal
vein cross behind the SMA.
In this particular image, the
transverse aspect of the
duodenum is out of plane
leaving a small distal
portion visible.
Plate 22
Superior
mesenteric
artery (SMA)
Distal
duodenum
L. Renal vein
Aort
a
46
Pt A - Axial VIBE
Plate 23
47
Pt A - Axial VIBE
Plate 24
48
Pt A - Axial VIBE - Origin of the Renal Arteries

Falciform ligament
Gastric antrum
Hepatic
flexure
Body of gallbladder
Duodenum (1st
part)
Head of
pancreas
Duodenum (2nd
part)
Hilum of right
kidney
Ligamentum teres
fissure
Gastric body
Superior mesenteric
vein
Superior mesenteric
artery
Small bowel
L. renal vein
L. renal artery
Hilum of left kidney
Inferior vena cava
Plate 24
49
Pt A - Axial VIBE
Plate 25
50
Pt A - Axial VIBE - Clinical Relationships of

the GallBladder
Gallbladder
An important clinical relationship

exists between the gallbladder
and the GI tract. In this image
the hepatic flexure lies adjacent
and medial to the body of the
gallbladder. As the gallbladder
ascends its neck abuts the
superior and/or descending
duodenum (which in this image
lies medial to the flexure, see
plate 59). In gallstone ileus, a
stone from the gallbladder tracks
through the wall of the
gallbladder and enters the
duodenum causing obstruction at
the narrow lumen of the ileocecal
valve. If the stone forms a fistula
with the hepatic flexure, and
enters the colon, ileus is unlikely
due to the wide colonic lumen.
Hepatic
flexure
Duodenum
(descendin
g)
Plate 25
51
Pt A - Axial VIBE
Plate 26
52
Pt A - Axial VIBE
Plate 27
53
Pt A - Axial VIBE - Renal Hilum
Duodenum (3nd
part)
Ligamentum
teres
fissure
Head of pancreas
Body of gallbladder
Superior mesenteric
vein
Transverse colon
Hepatic
flexure
Duodenum (2st
part)
R. renal pelvis
Hepatorenal recess
(Morrisons pouch)
Superior mesenteric
artery
Small bowel
L. renal vein
Hilum of left kidney
Inferior vena
cava
Deep back muscles
Renal pelvis fat

Hilum of right
kidney
Quadratus
lumborum
Psoas
muscle
Plate 27
54
Pt A - Axial VIBE
Plate 28
55
Pt A - Axial VIBE
Plate 29
56
Pt A - Axial VIBE - Kidney and Retroperitoneum

The kidneys are retroperitoneal
structures that reside at the level of
T12 to L3, with the right typically
being lower than the left due to the
presence of the liver. It is
encapsulated and housed, along with
the adrenal glands, within the
perirenal space. This space is
surrounded by Gerotas fascia. The
anterior and posterior pararenal space
surround Gerotas fascia with an
additional layer of adipose tissue (see
slide 74 for a more detailed look at
the retroperitoneum).
Anterior
pararenal
space
Perirenal space
These retroperitoneal locations have

clinical relevance when staging for
renal cell carcinoma or assessing for
renal infection or trauma.
In terms of relations, the kidney is
well connected, coming into contact
(through peri- and pararenal spaces)
bilaterally with the adrenals and
diaphragm superiorly and the
quadratus lumborum and psoas
muscles inferomedially. On the right
side the kidney is adjacent to the
liver, duodenum, and ascending
colon. On the left side the kidney is
in contact with spleen, stomach,
pancreas, jejunum, and descending
Kidne
y
Perirenal space
Posterior
pararenal
space
Plate 29
57
Pt A - Axial VIBE
Plate 30
58
Pt A - Axial VIBE - Hepatic Flexure

Superior
mesenteric artery
Superior
mesenteric vein
Aorta
Transverse colon
Duodenu
m
Fundus of
gallbladder
Hepatic flexure
Inferior vena cava
Lumbar vessels
Quadratus
lumborum
Deep back muscles
Small bowel
Anterior pararenal
space*
Flank stripe*
Perirenal space*
Posterior pararenal
space*
Ureter
Psoas muscle
Plate 30
*
Marked structures of retroperitoneum will be discussed in the following

slide.
59
A Simplified Overview of the

Retroperitoneal Spaces
Liver
Gastric
body
Pancreas
Anterior
Pararena
l
space
Flank stripe
Perirena
l space
Right
kidney
Inferior
vena cava
Spleen
Transversal
is
fascia
Gerotas
fascia
Left
kidney
Posterior
Pararena
l
space
60
Pt A - Axial VIBE
Plate 31
61
Pt A - Axial VIBE
Plate 32
62
Pt A - Axial VIBE
Plate 33
63
Pt A - Axial VIBE - Lower Poles of Kidneys

Transverse colon
Aort
a
Fundus of gall
bladder
Small bowel
Inferior vena cava
L. ureter
Live
r
R. ureter
Psoas muscle
Quadratus
lumborum
Erector spinae
Plate 33
64
Pt A - Axial VIBE
Plate 34
65
Pt A - Axial VIBE
Plate 35
66
Pt A - Axial VIBE
Plate 36
67
Pt A - Axial VIBE
Plate 37
68
Pt A - Axial VIBE
Plate 38
69
Pt A - Axial VIBE
Plate 39
70
Pt A - Axial VIBE
Plate 40
71
Pt A - Coronal Plane - VIBE Reformatted
Plate 41
72
Plate 42
73

Gallbladder
R. ventricle
Diaphragm
Falciform
ligament
Liver
Ligamentum
teres
Gallbladder
Hepatic flexure
Gastric body
Transverse
colon
Small bowel
Plate 42
74
Plate 43
75
Plate 44
76

Transverse Colon
L.
ventricle
Diaphragm
R.
ventricle
L. lobe of liver
Portal vein
R. lobe of liver
Gastric
fundus
Gastric
body
Splenic flexure
Gastric antrum
Fundus of
gallbladder
Hepatic flexure
Transverse colon
Small bowel
Plate 44
77
Plate 45
78
Plate 46
79

Pancreas and Splenic and Superior Mesenteric Vein
The pancreas
can be
subdivided
into five
segments.
They include a
head, neck,
uncinate
process, body
and tail.
In this image,
the body and
neck of the
pancreas are
located
centrally,
anterior to the
splenic vein
(out of plane).
Plate 46
Neck of
pancrea
s
Body of
pancrea
s
Superior
mesenteric
vein
The pancreas is
a
retroperitoneal
structure that
has many close
anatomic
relations. One
such relation
occurs posterior
to the neck of
the pancreas,
and involves the
union of the
splenic vein and
superior
mesenteric vein
(SMV) to form
the portal vein.
This image is in
the plane of the
pancreas and
the more
anteriorly
situated SMV.
80
Plate 47
81

Union of Splenic and Superior Mesenteric
L.
Veins
ventricle
Diaphragm
R.
Gastric ventricle
body/fundus
Splenic flexure
Body of pancreas
Portal vein
R. and
L.
hepatic
Neck
of
arteries
pancrea
s
Gallbladder
Duodenum
(descendin
g) flexure
Hepatic
Plate 47
Ascending colon
Head of pancreas
Superior
mesentericSplenic
v.
v.
Superior
mesenteric
a. aorta
Abdominal
Small
bowel
82
Plate 48
83

Branching of the Celiac artery
R. ventricle
L. ventricle
Ligamentum
teres
L. gastric artery
Hepatic artery
Portal vein
Celiac
artery
Hepatic flexure
Aorta
Inferior vena
cava
Gastric
body/fundus
Body of
pancreas
Small bowel
Splenic v.
Superior
mesenteric artery
Plate 48
84
Plate 49
85

Portal Vein
R.
atrium
Inferior vena
cava
Right hepatic
vein
Celiac artery
Portal vein
Superior
mesenteric a.
Abdominal aorta
Hepatic flexure
Inferior vena
cava
L. ventricle
Gastric fundus
Spleen
Body of
pancreas
Splenic v.
Small bowel
L. renal vein
Plate 49
86
Plate 50
87

Course of the Inferior Vena Cava (IVC)
Ascending from the confluence of

the common iliac veins the IVC
travels parallel and a few
centimeters to the right of the
vertebral column. The IVC
crosses anterior to the right renal
artery, receiving the right and
left renal vein. The left renal vein
crosses over the aorta anterior
and parallel to the left renal
artery.
Along with also receiving
gonadal, suprarenal, and lumbar
veins along this course, the IVC
next passes along the inferior
visceral border of the liver where
it receives input from the three
hepatic veins.
Right
atrium
IVC
Right renal
artery
IVC
Following this the IVC passes

through the vena caval foramen
to then enter the right atrium.
This image illustrates the IVC
passing the right renal artery
anteriorly, the liver posteriorly,
and entering the right atrium of
the heart.
Plate 50
88
Plate 51
89

Esophagogastric Junction
Spleen
R. atrium
Esophagus
Gastric cardia
Body of pancreas
Superior
branch of
portal vein
Inferior
branch of
portal vein
Plate 51
Celiac artery
Splenic v.
Aort
a
Hepatic flexure
Inferior vena
cava
L. renal arteries
Psoas muscles
Small bowel
90
Plate 52
91
Plate 53
92

Adrenal Glands
Thoracic aorta
Hepatic
vein
Inferior vena
cava
Abdominal aorta
R. adrenal gland
Right renal arteries
R. kidney
Gastric cardia
Spleen
Splenic v.
L. adrenal gland
L. kidney
L. renal arteries
Hepatorenal
recess
Psoas m.
Plate 53
93
Plate 54
94
Plate 55
95
Plate 56
96

Renal Hilum and T12 Vertebral Body
Thoracic aorta
R. lower lobe of lung
Serratus anterior
m.
Hepatic vein
Renal sinus fat
R. kidney
Hepatorenal
recess R. psoas
m.
L. lower lobe of
lung
Hemiazygos v
Spleen
Splenic hilum
L. renal calyx
L. renal pelvis
L. kidney
L. psoas
m.
Plate 56
97
Plate 57
98

Splenic Hilum
Thoracic aorta
R. lower lobe of
lung
Serratus anterior
m.
L. lower lobe of
lung
Splenic hilum
Spleen
Right lobe of liver

(posterior
segment)
R. kidney
Hepatorenal
recess
R. psoas
m.
Splenic artery
L. kidney
Renal calyx
L. psoas
m.
Spinal canal
Plate 57
99
Plate 58
100
Plate 59
101
Plate 60
102

Spinal Canal at T10/Posterior Kidneys
L. lower lobe of
lung
R. lower lobe of lung

Right lobe of liver
(posterior
segment) recess
Hepatorenal
Spinal canal
Spleen
Perirenal fat
L. kidney
Erector spinae
m.
R. kidney
Spinal cord
Plate 60
103
Pt A - Sagittal Plane - VIBE Reformatted
Plate 61
104
Plate 62
105
Plate 63
106

Right Lobe of Liver
R. lung
Intercostal m.
Liver
(vertical
span)
Anterior ribs
Posterior ribs
Subcutaneous fat
Plate 63
107
Plate 64
108
Plate 65
109

Gallbladder
Hepatic veins
R. lobe of liver
(anterior segment)
Branch of portal
vein
Gallbladde
r
Transverse colon
R. lobe of liver
(posterior
segment)
Hepatorenal
recess
R.
kidney
Posterior pararenal
fat
Perirenal fat
Ascending colon
Plate 65
110
Plate 66
111

Hepatorenal Recess
Superio
r
30
Anterio
r
The peritoneal recess

between the liver and
kidney occupies an
important clinical location in
the abdomen. In the supine
position this recess, also
known as Morrisons
pouch, is the lowest point
where fluid (e.g ascites) can
collect.
Anterio
r
Superio
r
Hepatorenal
Recess
Plate 66
112
Plate 67
113

Medulla of Right Kidney
R. Lobe of liver
(anterior segment)
Hepatic veins
R. Lobe of liver
(posterior
segment)
Pararenal fat
Portal
vein
Body of gallbladder
Renal calyx
R. kidney
(cortex)
R. Kidney
(medulla)
Hepatic
flexure
Plate 67
114
Plate 68
115

Porta hepatis
Common bile duct
Portal
vein
Hepatic
artery
Plate 68
The porta hepatis is the port of entrance and exit

to and from the liver for the portal triadportal vein,
hepatic artery, and common bile duct. This sagittal
MR image provides a cross section of the portal
triad.
116
Plate 69
117

Inferior Vena Cava
Hepatic
artery
Portal vein
R. lumbar
vessels
Inferior vena cava

Psoas m.
Plate 69
118
Plate 70
119
Plate 71
120

Superior Mesenteric Vein
Thoracic
aorta
Inferior vena
cava
Liver
Abdominal
aorta
Spinal
canal
Duodenu
m
Uncinate
process
Hepatic artery
Head of pancreas
Hepatic flexure
Superior mesenteric
vein
Plate 71
121
Plate 72
122

Aorta, Celiac Artery, and Superior Mesenteric Artery
Aorta
Esophagogastric
junction
Hepatic
artery
Left lobe of liver
Celiac
artery
Neck of
pancreas
Duodenum
(superior)
Splenic
vein colon
Transverse
Plate 72
L. renal vein
Ascending
colon
Superior mesenteric
artery
Duodenum (transverse)
123
Plate 73
124
Plate 74
125
Plate 75
126

Medulla of Left Kidney
Gastric fundus
Left lobe of
liver (lateral
segment)
Gastric
body
Renal calyx
Transverse
colon
Spleen
Pancreatic body and
tail
Left kidney
(medulla)
Perirenal fat
Small bowel
Left kidney
(cortex)
Plate 75
127
Plate 76
128

Lesser Sac
The lesser sac is a blind pouch of peritoneum
that is bordered antero-superiorly by the
posterior wall of the stomach and the lesser
omentum and postero-inferiorly by the
peritoneum overlying the body of the pancreas.
Gastric
fundus
Body
and tail
of
pancrea
s
Gastric
body
In this image, the lesser sac can be seen on end

as a thin hypointense area between the stomach
and the pancreas.
Plate 76
129
Plate 77
130

Spleen
Apex of
heart
Splenic flexure
Splenic
vein
Gastric
body
Small bowel
Spleen
Left kidney
Plate 77
131
Pt B - MRA with contrast, maximum

intensity projection 3D
reconstruction of superior
mesenteric and celiac arteries
Plate 78
132

Aorta
Hepatic
artery
Gastroduodenal
artery
R. renal
artery
Celiac
trunk
Splenic
artery
Superior mesenteric
artery
Plate 78
133

Plate 79
134

Aorta
Lumbar arteries
Hepatic artery
Splenic artery
R. renal
artery
Celiac trunk
Superior mesenteric
artery
L. renal
artery
Plate 79
135

Plate 80
136

Plate 81
137

Celiac
trunk
Superior mesenteric
artery
Inferior mesenteric
artery
Plate 82
138

Plate 83
139

Left gastric artery
Hepatic artery
Celiac trunk
Splenic artery
Superior mesenteric
artery
Lumbar arteries
Plate 83
140
Pt C - MRA with contrast, maximum

reconstruction of renal arteries
Plate 84
141

Lumbar arteries
Right renal artery
Aorta
Left renal artery

L. ureter
Superior mesenteric
artery
Plate 84
142

Plate 85
143

Plate 86
144

Aorta
Superior
mesenteric artery
L. Ureter
Left renal artery
Right renal artery
Plate 86
145

Plate 87
146

Aorta
Superior
mesenteric
artery
Branches of L.
renal artery
L. Renal
artery
Plate 87
147
Correlation of Axial, Coronal, and Sagittal MR Plate 1

Liver and Gastroesophageal junction
When examining the GI tract, a useful tool for

orientation is the stomach. If one follows axial
slices in the caudal direction from the diaphragm
and GE junction downward, an easy landmark of
the stomach is its characteristic longitudinally
oriented rugae. These provide an initial
reference point from which one can follow the GI
tract distally through the duodenum to its distal
transverse and ascending segments.
148

Spleen
Given its
location
immediately
adjacent to
the posterior
and lateral
ribs and its
lack of
surrounding
adipose
tissue (unlike
the kidneys),
the spleen is
very
susceptible to
trauma. MR
imaging of
the abdomen
can serve as
a useful tool
in assessing
splenic
trauma.
149

Celiac Trunk
The celiac artery arises off of

the aorta at the level of T12.
It trifurcates into the splenic,
hepatic and left gastric
arteries. These arteries supply
the foregut of the GI tract
distal esophagus, stomach,
duodenum, pancreas, liver,
gall bladder, and spleen.
150
Correlation of Axial, Coronal, and Sagittal Plate 4

Pancreas
Together these images capture the

body and tail of the pancreas. To
image the entire view of the
pancreas an oblique section can
be helpful.
151
The
Pancreas
This image
illustrates four
main segments
of the pancreas
in one plane.
These include
the tail, body,
neck, and head
of the pancreas.
Due to the fact
that the
pancreas
typically slopes
inferiorly from
the tail at the
splenic hilum to
its head
adjacent to the
duodenum, this
image was
reconstructed in
an oblique
plane.
Head
Neck
Body
Tail
152

Gallbladder
Fluid is hypointense (dark) on these T1 weighted VIBE

images. The fluid-filled gallbladder illustrates this
appearance. To further examine the gallbladder and
biliary tree, T2 weighted MRCP (MR
cholangiopancreatography) can be used.
153
MRCP of the Biliary Tree
R. hepatic
duct
Cystic
duct
Common bile
duct
Gallbladde
r
L. Hepatic
duct
Common
hepatic
duct
Pancreatic
duct
154

Kidney (Right Upper Pole)
155
Correlation of Axial, Coronal, and Sagittal Plate 7

Kidney (Left Hilum)
156

Kidneys (Left Lower Pole) and Vertebral Musculature
Ureter
Vertebr
al body
Psoas
muscl
e
Deep
back
mm.
Quadratus
lumborum
Erector
spinae
The lower poles

of the kidneys
lie adjacent
and anterolateral to the
muscles of the
back. These
include the
psoas,
quadratus
lumboratum,
deep back
muscles, and
intermediate
(erector
spinae) back
muscles.
Notice the
small
hypointense
circular slice of
the left ureter
lying on the left
psoas muscle.
157
References
Christofordis, A Atlas of Axial, Sagittal, and Coronal Anatomy
with CT and MRI 1988
Novelline, RA Living Anatomy: A Working Atlas Using
Computed Tomography, Magnetic Resonance, and
Angiography Images 1st edition, 1987
Moore, K and Dalley, A Clinically Oriented Anatomy 4th
edition, 1999
Fleckenstein, P Anatomy in Diagnostic Imaging 2nd edition,
2001
158
Special Thanks
Pamela Lepkowski, Education
Coordinator at Beth Israel Deaconess
Medical Center for technical
assistance and editing.
159

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MRI Atlas of the Abdomen

Jeff Velez HMS3

an outline of the anatomy of the abdomen via MR imaging.

By coupling this review of how an MR image is created

understanding of the principles underlying its production.

4 Key Parameters of MRI

The relaxation times of protons shifting from a

higher to lower energy level, are referred to as T1

T1 and T2 represent relaxation time constants.

and T2) to create the desired tissue differentiation.

T1 weighted images vs. T2

contrast on T1 vs. T2 weighted images.

On a T2 weighted image the protocol used is one that

will result in tissue with long T1 and T2 (fluid) having a

This protocol involves using a TR and TE that are

Beyond T1 and T2Abdominal MRI

technology, developments in the pulse sequences used have

Volumetric Interpolated Breath-hold

fast acquisition time, thus reducing motion artifact and allowing

Anatomy of the Abdomen

We have used images from

MR settings: VIBE sequence, MR abdomen

Pt A - Axial VIBE - Dome of the Liver

Pt A - Axial VIBE - Hepatic Veins

Pt A - Axial VIBE - Hepatic Divisions

The superior aspect of the liver serves as a good reference point

Pt A - Axial VIBE - Splenic Hilum

Pt A - Axial VIBE - Adrenal Gland and Spleen

Pt A - Axial VIBE - Adrenal Glands

This image illustrates

Pt A - Axial VIBE - Celiac Trunk

A notable anatomic relationship exists at the level of the

Pt A - Axial VIBE - Body of Pancreas

Pt A - Axial VIBE - Origin of SMA

Inferior vena cava

Pt A - Axial VIBE - Relationships of the

Pt A - Axial VIBE - Origin of the Renal Arteries

Inferior vena cava

Pt A - Axial VIBE - Clinical Relationships of

An important clinical relationship

Pt A - Axial VIBE - Renal Hilum

Renal pelvis fat

Pt A - Axial VIBE - Kidney and Retroperitoneum

These retroperitoneal locations have

Pt A - Axial VIBE - Hepatic Flexure

Marked structures of retroperitoneum will be discussed in the following

A Simplified Overview of the

Pt A - Axial VIBE - Lower Poles of Kidneys

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted

Pt A - Coronal Plane - VIBE Reformatted