Comparison of mri with postcontrast ct for the evaluation of acute abdominal trauma

We compared the ability of MRI and CT to detect and characterize abdominal visceral injury. Seven patients with contrast-enhanced abdominal CT interpreted as showing definite (five patients) or possible (two) solid organ injury following blunt abdominal trauma were referred for abdominal MRI with a mean interval of 3 days between modalities. Tl-weighted and T2-weighted spin echo sequences were obtained in all patients. Gradient-recalled echo (GRE) sequences (22-25/12-13/60° flip angle) were obtained in five cases. Both CT and MR allowed detection of complex splenic lacerations in two patients and complex hepatic injuries in three other patients. A sixth patient had subtle periportal hypodensity noted on CT which was not detected prospectively on MRI. One patient had a right adrenal hematoma detected on MRI but not on CT. Relative lesion conspicuity and extent were judged equal on CT and T2- weighted imaging. The Tl-weighted and GRE imaging were judged inferior to CT. We conclude that MRI offers no significant advantage over CT for the routine evaluation of acute abdominal trauma.