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Atlas MRI Abdomen

This photo gallery presents the anatomy of the abdomen by means of MRI.

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Axial T1-weighted images
Axial T1-weighted fat-suppressed images after injection of contrast
Axial T2-weighted fat-suppressed images

Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 1.
1, Lower lobe of the left lung. 2, Thoracic aorta. 3, Azygos vein. 4, Esophagus. 5, Heart. 6, Dome of the liver. 7, Lower lobe of the right lung.
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  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 1.
    1, Lower lobe of the left lung. 2, Thoracic aorta. 3, Azygos vein. 4, Esophagus. 5, Heart. 6, Dome of the liver. 7, Lower lobe of the right lung.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 2.
    1, Left hepatic vein. 2, Middle hepatic vein. 3, Right hepatic vein. 4, Inferior vena cava. 5, Dome of the liver. 6, Abdominal aorta. 7, Lower lobe of the right lung. 8, Inferior lobe of the left lung. 9, Spleen. 10, Vertebral canal. 11, Rib.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 3.
    1, Porta hepatis. 2, Portal vein. 3, Stomach. 4, Diaphragm. 5, Right lobe of the liver. 6, Left lobe of the liver. 7, Spleen. 8, Lung. 9, Abdominal aorta.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 4.
    1, Crus of diaphragm. 2, Right lung. 3, Left lobe of the liver. 4, Portal vein. 5, Right lobe of the liver. 6, Stomach. 7, Pancreas. 8, Aorta. 9, Spleen. 10, Longuissimus dorsi. 11, Vertebral canal.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 5.
    1, Portal vein. 2, Right branch of the portal vein. 3, Aorta. 4, Inferior vena cava. 5, Splenic vein. 6, Spleen. 7, Vertebral body. 8, Body of the pancreas.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 6.
    1, Liver. 2, Portal vein. 3, Hepatic artery. 4, Celiac trunk. 5, Inferior vena cava. 6, Right adrenal. 7, Aorta. 8, Left adrenal. 9, Splenic vein. 10, Pancreas. 11, Spleen. 12, Splenic hilus.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 7.
    1, Diaphragm. 2, Liver. 3, Inferior vena cava. 4, Aorta. 5, Celiac trunk. 6, Spleen.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 8.
    1, Liver. 2, Colon. 3, Small bowel. 4, Inferior vena cava. 5, Aorta. 6, Splenic hilus.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 9.
    1, Liver. 2, Pancreas. 3, Superior mesenteric vein. 4, Superior mesenteric artery. 5, Inferior vena cava. 6, Aorta. 7, Spleen. 8, Top of the right kidney. 9, Transverse colon. 10, Small bowel. 11, Left adrenal.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image. Image 10.
    1, Liver. 2, Right kidney. 3, Aorta. 4, Inferior vena cava. 5, Left kidney. 6, Left renal vein. 7, Spine. 8, Spleen. 9, Superior mesenteric artery. 10, Superior mesenteric vein. 11, Pancreas. 12, Colon. 13, Small bowel.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image after gadolinium. Image 11.
    1, Left lung. 2, Thoracic aorta. 3, Azygos vein. 4, Esophagus. 5, Inferior vena cava. 6, Left ventricle. 7, Right ventricle. 8, Dome of the liver. 9, Right lung. 10, Vertebral body.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image after gadolinium. Image 12.
    1, Liver. 2, Left hepatic vein. 3, Middle hepatic vein. 4, Right hepatic vein. 5, Inferior vena cava. 6, Esophagus. 7, Abdominal aorta. 8, Right inferior pulmonary lobe. 9, Left inferior pulmonary lobe. 10, Spleen. 11, Vertebral canal.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image after gadolinium. Image 13.
    1, Left lobe of the liver. 2, Portal vein. 3, Ligamentum venosum. 4, Right lobe of the liver. 5, Abdominal aorta. 6, Stomach. 7, Crus of diaphragm. 8, Spleen. 9, Right lung. 10, Left lung.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image after gadolinium. Image 14.
    1, Right diaphragm. 2, Left diaphragm. 3, Right lung. 4, Left lung. 5, Left lobe of the liver. 6, Portal vein. 7, Right lobe of the liver. 8, Porta hepatis. 9, Stomach. 10, Pancreas. 11, Aorta. 12, Splenic artery. 13, Spleen. 14, Inferior vena cava.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image after gadolinium. Image 15.
    1, Liver. 2, Portal vein. 3, Inferior vena cava. 4, Splenic vein. 5, Aorta. 6, Celiac trunk. 7, Body of the pancreas.. 8, Pancratic tail. 9, Spleen. 10, Right adrenal. 11, Left adrenal. 12, Diaphragm. 13, Lung.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image after gadolinium. Image 16.
    1, Liver. 2, Inferior vena cava. 3, Splenic vessels. 4, Aorta. 5, Superior mesenteric artery 6, Spleen. 7, Diaphragm. 8, Lung. 9, Small bowel.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image after gadolinium. Image 17.
    1, Liver. 2, Superior mesenteric vein. 3, Inferior vena cava. 4, Superior mesenteric artery. 5, Abdominal aorta. 6, Splenic vein. 7, Spleen. 8, Top of the right kidney. 9, Hepatic flexure of the colon. 10 Small bowel.

  • Atlas of MRI Anatomy of the Abdomen. Axial T1-weighted image after gadolinium. Image 18.
    1, Liver. 2, Superior mesenteric vein. 3, Inferior vena cava. 4, Left renal vein. 5, Abdominal aorta. 6, Superior mesenteric artery. 7, Right kidney. 8, Left kidney. 9, Spleen. 10, Colon.

  • Atlas of MRI Anatomy of the Abdomen. Axial T2-weighted fat-suppressed image. Image 19.
    1, Right lung. 2, Left lung. 3, Heart. 4, Aorta. 5, Vertebral body. 6, Spinal cord.

  • Atlas of MRI Anatomy of the Abdomen. Axial T2-weighted fat-suppressed image. Image 20.
    1, Right ventricle. 2, Left ventricle. 3, Dome of the liver. 4, Inferior lobe of the rightt lung. 5, Inferior lobe of the left lung. 6, Vertebral canal. 7, Descending aorta. 8, Rib.

  • Atlas of MRI Anatomy of the Abdomen. Axial T2-weighted fat-suppressed image. Image 21.
    1, Crus of diaphragm. 2, Right hepatic vein. 3, Middle hepatic vein. 4, Left hepatic vein. 5, Right lobe of the liver. 6, Left lobe of the liver. 7, Esophagus. 8, Aorta. 9, Spleen.

  • Atlas of MRI Anatomy of the Abdomen. Axial T2-weighted fat-suppressed image. Image 22.
    1, Hepatic vein. 2, Inferior vena cava. 3, Right lobe of the liver. 4, Left lobe of the liver. 5, Aorta. 6, Stomach. 7, Spleen. 8, Vertebral body. 9, Longuissimus dorsi.

  • Atlas of MRI Anatomy of the Abdomen. Axial T2-weighted fat-suppressed image. Image 23.
    1, Liver. 2, Portal vein. 3, Inferior vena cava. 4, Aorta. 5, Splenic artery. 6, Splenic vein. 7, Spleen.

  • Atlas of MRI Anatomy of the Abdomen. Axial T2-weighted fat-suppressed image. Image 24.
    1, Liver. 2, Portal vein. 3, Inferior vena cava. 4, Aorta. 5, Origin of the celiac trunk. 6, Splenic artery. 7, Splenic vein. 8, Spleen. 9, Vertebral canal.

  • Atlas of MRI Anatomy of the Abdomen. Axial T2-weighted fat-suppressed image. Image 25.
    1, Liver. 2, Gallbladder. 3, Portal confluence. 4, Inferior vena cava. 5, Aorta. 6, Superior mesenteric artery. 7, Splenic vein. 8, Spleen.

  • Atlas of MRI Anatomy of the Abdomen. Axial T2-weighted fat-suppressed image. Image 26.
    1, colon. 2, Liver. 3, Portal confluence. 4, Inferior vena cava. 5, Aorta. 6, Superior mesenteric artery. 7, Small bowel. 8, Splenic vein. 9, Spleen.

  • Atlas of MRI Anatomy of the Abdomen. Axial T2-weighted fat-suppressed image. Image 27 of 27.
    1, Liver. 2, Aorta. 3, Vertebral body. 4, Right kidney. 5, Left kidney. 6, Inferior vena cava.

Radiologists routinely use magnetic resonance imaging (MRI) to diagnose many upper abdominal tumors(1).

MRI is non-ionizing, making the modality more advantageous over other imaging sequences that involve higher radiation exposure. MRI can provide practical information and better soft tissue resolution than computed tomography (CT)(2-3).

The primary advantage of MRI in treating upper abdominal malignancies, particularly liver cancers, lies in CT’s difficulty to detect and characterize tumors. Additionally, MRI can better characterize some organs at risk, such as the common bile duct and distal biliary tree(4).

Upper abdominal organs are also subject to respiratory motion, bowel peristalsis, and daily positional variation. These conditions are suitable for online MRI guidance and adaptive radiation therapy(5-8).

The commercial availability of MRI-guided treatment units has increased. This boost in availability amplified the focus on online MRI-guided radiation therapy (MRgRT) for treating pancreatic cancer, liver cancer, kidney cancer, adrenal cancer, and upper abdominal metastases(9-11).

MRI simulation and online MRgRT are becoming more commonly used to identify gross tumor volume (GTV) and organs at risk (OAR). These modalities are useful in upper abdominal radiation planning and treatment (especially for pancreas and liver cancer)(12).

Experts have used two commercially integrated online MRgRT systems for treating patients with upper abdominal tumors:

  1. A 0.35T MRI scanner combined with 3 Cobalt-60 teletherapy heads or a 6X FFF linear accelerator and multileaf collimators (MRIdian, ViewRay)
  2. A 1.5T MRI scanner combined with a 6X linear accelerator (Unity MRLinac, Elekta AB)(13-14).

Other online MRgRT systems are in development. Among these systems are the 1.0T Australian MRI LINAC System (Australian MRI-LINAC Program, Sydney, Australia) and the 0.6T Aurora-RT System (MagnetTx, Edmonton, Alberta, Canada)(15-16).

The accurate definition of the GTV and OARs ensures safe radiation treatment. Precise definitions can realize the potential of real-time MRI-based image guidance and adaptive treatment planning(17).

Meanwhile, several standard tissue contouring atlases for radiation planning exist. However, they are CT-based(18-19).

Professionals expect online MRgRT to increase the accuracy and precision of radiation treatment delivery. The method also improves adaptive radiation therapy and allows response assessment throughout treatment(20).

With the increasing use of MRI, standardization of target volume and OAR definition via MRI have become necessary. 

Standardization improves the consistency of radiation treatment plans. Having standard definitions also facilitates high-quality collaborative studies and OAR dose-volume-toxicity analyses(21).

Many radiation oncologists have not routinely used MRI for simulation or guidance. Most radiation therapists also lack training in MRI anatomy(22).

An MRI-based atlas is useful in defining commonly used vocabulary (such as liver segments). An atlas can also define OARs that CT-based radiation therapy may not have consistently visualized or contoured.

Liver

Unenhanced MRI-defined GTV connects better with the pathologic GTV than other imaging modalities among patients with primary and secondary liver tumors. Other modalities include CT or positron emission tomography(23).

MRI in liver imaging has superior soft-tissue contrast. This advantage allows better detection and characterization of malignant and benign focal liver lesions(24).

The development of liver-specific MRI contrast agents (substances that make images clearer) has further improved MRI diagnostic yield in detecting and characterizing lesions.

It is necessary to detect focal liver lesions early, particularly malignant ones. Patients’ survival rates improve upon the resection of liver metastases of some malignancies, such as colorectal cancer(25).

Spleen

The spleen is an intraperitoneal (within the abdomen) organ located in the abdomen’s upper-left quadrant. The gastrosplenic and splenorenal ligaments, two of the spleen’s ligaments, maintain the spleen’s normal anatomic position(26).

CT and ultrasound are the primary modalities that radiologists use for imaging the spleen. In some instances, MRI can be helpful.

The adult spleen’s average signal on MRI is hyperintense on T2-weighted imaging. On T1-weighted imaging, the spleen is hypointense relative to the liver(27). Deviations from this pattern can reflect iron overload disease processes, including hemochromatosis and hemosiderosis.

Pancreas

Using MRI for target volume delineation in pancreatic cancer has also resulted in smaller target volumes and reduced the interobserver variation. This occurrence is likely due to the improved soft-tissue contrast(28-29).

Recently, a research group published specific MRI-based GTV and OAR contouring recommendations in pancreatic cancer(30-31).

Pancreatic ductal adenocarcinoma is a typically malignant tumor. This condition, which accounts for 85% to 90% of all malignant pancreatic tumors, is the fourth most common cause of cancer death worldwide(32).

The remaining tumors of the pancreas are a diverse group of pancreatic neoplasms. These abnormal tissue masses comprise endocrine tumors, cystic pancreatic neoplasms, and other uncommon pancreatic tumors(33).

  1. Lukovic, J., Henke, L., Gani, C., Kim, T. K., Stanescu, T., Hosni, A., Lindsay, P., Erickson, B., Khor, R., Eccles, C., Boon, C., Donker, M., Jagavkar, R., Nowee, M. E., Hall, W. A., Parikh, P., & Dawson, L. A. (2020). MRI-Based Upper Abdominal Organs-at-Risk Atlas for Radiation Oncology. International journal of radiation oncology, biology, physics, 106(4), 743–753. https://doi.org/10.1016/j.ijrobp.2019.12.003
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