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IS CT Scan of abdomen for pancreatic pathology is more informative than MRI of abdomen?

DOCTOR OF THE MONTH - Apr 2014
Apr 2014
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Hi, My gastroenterologist says that I should have a CT scan of the abdomen instead of an MRI as the MRI misses part of the pancreas and is not better than the CT for this area. Is this true and which part of the pancreas is the MRI unable to see? Is the CT able to produce the better images and are there serious radiation concerns with abdominal CT? Thanks.
Posted Mon, 10 Feb 2014 in X-ray, Lab tests and Scans
 
 
Answered by Dr. Indu Kumar 55 minutes later
Brief Answer: I agree with your Gastroenterologist. Detailed Answer: Hello XXXXXXX Thanks for writing to us I agree with your Gastroenterologist. Contrast CT Scan of abdomen for pancreatic pathology is more informative than MRI of abdomen. CT scan provides detail images of pancreatic pathology and its relationship to the surrounding structures such as major blood vessels around the pancreas.This is the limitation of MRI as compared to CT Scan. Volume rendering technique of CT Scan give very clear images. Detail information is very important in proper treatment planning of pancreas. In general for pancreatic study,MRI is less useful as compared to a CT scan and it is advised only in special circumstances. There are no serious radiation concern during contrast CT scan of abdomen. It is far below the recommended level of maximum allowable radiation.So,you don't concern about radiation. Now a days,Spiral CT technique causes much less radiation dose as compared to previous CT Scan machines. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
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Follow-up: IS CT Scan of abdomen for pancreatic pathology is more informative than MRI of abdomen? 15 hours later
Dear Dr. XXXXXXX Thanks for your information. Would the MRI be better for a general abdominal scan or would CT still be the preferred option? I had always thought that MRI was better at imaging soft tissue. Do you know if there is any area that MRI misses in the case of the pancreas, such as parts of the pancreas being unable to be seen through ultrasound. Regards.
 
 
Answered by Dr. Indu Kumar 2 hours later
Brief Answer: Please find detail answer below. Detailed Answer: Hello XXXXXXX Thanks for writing back Yes,MRI is ideal for soft tissue imaging.In abdominal pathology choice of MRI or CT Scan depend upon organ involved and probable diagnosis. Initially,Ultrasound is done for screening.It is very sensitive for hepatobiliary diseases. If there is any abnormality in USG then further investigations like CT Scan or MRI is done . MRI is ideal for pelvic diseases,adrenal pathology,hepatic diseases,lymph node assessment,invasion to surrounding structures etc. Whereas CT scan is more informative in pancreatic,renal pathology,lesions that contain calcifications etc. So,choice of investigation varies depending upon condition. Main problem with MRI in pancreatic pathology is assessment of surrounding blood vessels.MRI will not miss any anatomical part. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
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Follow-up: IS CT Scan of abdomen for pancreatic pathology is more informative than MRI of abdomen? 21 hours later
Thanks Dr. XXXXXXX for the detailed information. Would it be correct to say that even with contrast used such as during the MRCP procedure, MRI is only able to assess the functional parts surrounding the pancreas and is not as effective is assessing the surrounding structural connecting components as is CT? Lastly, I have also had fatty liver detected via ultrasound. I understand that you recommend MRI to assess the liver (hepatic disease). Does the condition of fatty liver make it more difficult to assess other problems such as tumours in the liver and is it easy to detect other abnormalities given what I presume would be an uneven image due to the fatty liver condition? Thankyou, Regards.
 
 
Answered by Dr. Indu Kumar 5 hours later
Brief Answer: Please find detail answer below. Detailed Answer: Hello XXXXXXX Thanks for writing back Yes,Contrast CT Scan of abdomen is better than contrast MRI for assessment of blood vessels surrounding the pancreas. Initially you don't need MRI for fatty liver.Ultrasound is very sensitive for this condition.Besides this management doesn't get affected.Findings of USG are comparable with MRI in fatty liver disease. You can have elastography.This is done for assessing elasticity of liver cells.If elastography scoring is high,then there is more propensity of getting converted into cirrhosis. During USG fatty liver doesn't generally interfere with assessment of other conditions like tumour etc. Definitely MRI is needed in selected cases. You don't worry.Most of the cases of fatty liver are reversible.You need to change your diet and life style. You should increase your physical activity and do brisk walking and exercise. You should take lot of fruits and vegetables in your diet. Avoid saturated & trans fat,fried food,red meat,high fat milk products. Use olive oil for cooking. Avoid smoking and alcohol if you take these things. You should take restricted amount of salt in your diet. You need few investigation like Lipid profile.If there is altered lipid profile then you may need medicines. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
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