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Kazan StateKazan State
Medical UniversityMedical University
Department of radiologyDepartment of radiology
Liver, bile duct, pancreas and spleen
Overview of the abdomenOverview of the abdomen
by:Mahiby:Mahi
And hereAnd here, we are about to describe one of the most, we are about to describe one of the most
important organ in the abdominal region.important organ in the abdominal region.
The liverThe liver
The liver is a large,The liver is a large,
meaty organ that sitsmeaty organ that sits
on the right side of theon the right side of the
Abdomen . WeighingAbdomen . Weighing
about 3 pounds, theabout 3 pounds, the
liver is reddish-brown inliver is reddish-brown in
color and feels rubberycolor and feels rubbery
to the touchto the touch
by:Mahiby:Mahi
by:Mahiby:Mahi
Liver segments and lobulesLiver segments and lobules
The liver has two largeThe liver has two large
sections, called the rightsections, called the right
and the left lobes.and the left lobes.
And also consist of eightAnd also consist of eight
segments.segments.
The first segment isThe first segment is
cuadatecuadate
The right contain 4The right contain 4
segmentssegments
The left are 3 segments .The left are 3 segments .
Diagram showing the
segments
by:Mahiby:Mahi
liver’s functionliver’s function
The liver's main job is to filterThe liver's main job is to filter
the blood coming from thethe blood coming from the
digestive tract, before passing itdigestive tract, before passing it
to the rest of the body.to the rest of the body.
The liver also detoxifiesThe liver also detoxifies
chemicals and metabolizeschemicals and metabolizes
drugs. As it does so, the liverdrugs. As it does so, the liver
secretes bile that ends up backsecretes bile that ends up back
in the intestines. The liver alsoin the intestines. The liver also
makes proteins important formakes proteins important for
blood clotting and otherblood clotting and other
functions.functions.
by:Mahiby:Mahi
Blood supply and venousBlood supply and venous
drainagedrainage
The blood supply of the liverThe blood supply of the liver
is delivered through theis delivered through the
portal veinportal vein and theand the hepatichepatic
arteryartery. The. The hepatic arteryhepatic artery
brings oxygenated blood tobrings oxygenated blood to
the hepatic tissues, while thethe hepatic tissues, while the
portal vein collects theportal vein collects the
deoxygenated blood from thedeoxygenated blood from the
abdominal contents and filtersabdominal contents and filters
it, eliminating toxins andit, eliminating toxins and
processing the nutrientsprocessing the nutrients
TheThe hepatic portal systemhepatic portal system
is the system ofis the system of veinsveins
comprising thecomprising the
hepatic portal veinhepatic portal vein and itsand its
tributaries. It is also called thetributaries. It is also called the
portal venous system.portal venous system.
by:Mahiby:Mahi
Diagram for the vascularDiagram for the vascular
system of liversystem of liver
by:Mahiby:Mahi
Biliary tractBiliary tract
RIGHT AND LEFT HEPATIC DUCTSRIGHT AND LEFT HEPATIC DUCTS
MERGES TO FORM THEMERGES TO FORM THE COMMONCOMMON
HEPATIC DUCTHEPATIC DUCT
COMMON HEPATIC DUCTCOMMON HEPATIC DUCT LEAVEAS THELEAVEAS THE
LIVER AND GOINING TOLIVER AND GOINING TO CYSTIC DUCTCYSTIC DUCT
TO FORM THETO FORM THE COMMON BILE DUCTCOMMON BILE DUCT
FINALLY DRAIN INTOFINALLY DRAIN INTO THE DOEDENUMTHE DOEDENUMby:Mahiby:Mahi
And nowAnd now;; it’s time to discoverit’s time to discover
how your abdomen looks likehow your abdomen looks like
inside thisinside this Tunnel.Tunnel.
by:Mahiby:Mahi
MRIMRI
1.MRI1.MRI plain scan ::
SSequence————axialaxial 、、 coronalcoronal T1WT1W 、、 T2WT2W
FIESTAFIESTA 、、 DWIDWI 、、 double echodouble echo
2. MRI2. MRI enhancement scanning
3.3. MRMRAA
4.4. MRCPMRCP Magnetic Resonance
Cholangiopancreatography
by:Mahiby:Mahi
1. CORONAL PLANES1. CORONAL PLANES
by:Mahiby:Mahi
AXIAL PLANES
by:Mahiby:Mahi
3. SAGITTAL3. SAGITTAL
PLANESPLANES
by:Mahiby:Mahi
4. MR4. MR
ANGIOGRAPHYANGIOGRAPHY
by:Mahiby:Mahi
 PositioningPositioning
 Position the patient in supine position with head pointingPosition the patient in supine position with head pointing
towards the magnet (head first supine) .towards the magnet (head first supine) .
 Position the patient over the spine coil and place the body coilPosition the patient over the spine coil and place the body coil
over the upper abdomen (nipple down to iliac crest) .over the upper abdomen (nipple down to iliac crest) .
 Securely tighten the body coil using straps to preventSecurely tighten the body coil using straps to prevent
respiratory artefacts .respiratory artefacts .
 Give a pillow under the head and cushions under the legs forGive a pillow under the head and cushions under the legs for
extra comfort .extra comfort .
 Centre the laser beam localizer over xiphoid process ofCentre the laser beam localizer over xiphoid process of
sternum .sternum .
by:Mahiby:Mahi
Body Coil
by:Mahiby:Mahi
3 Survey ( Scout ) .3 Survey ( Scout ) .
by:Mahiby:Mahi
Coronal - Axial - SagittalCoronal - Axial - Sagittal
by:Mahiby:Mahi
The Sequences Before Inject TheThe Sequences Before Inject The
ContrastContrast
( Pre-Contrast )( Pre-Contrast )
1- Axial ( T2 – T1 – *T2 Heavy )1- Axial ( T2 – T1 – *T2 Heavy )
by:Mahiby:Mahi
Plan the Axial slices on the Coronal plane ;
* angle the position block across the liver as shown.
* Check the positioning block in the other two planes.
* Slices must be sufficient to cover the whole liver from the
diaphragm down to the iliac crest
by:Mahiby:Mahi
2- Coronal ( T2 – T1 )2- Coronal ( T2 – T1 )
by:Mahiby:Mahi
Plan the coronal slices on the axial image;Plan the coronal slices on the axial image;
* position the block across the liver as shown.* position the block across the liver as shown.
* Check in the other two planes , Slices must be sufficient to cover the* Check in the other two planes , Slices must be sufficient to cover the
whole liver from the anterior abdominal wall to the posterior abdominalwhole liver from the anterior abdominal wall to the posterior abdominal
wall .wall .
by:Mahiby:Mahi
The Sequences After Inject The ContrastThe Sequences After Inject The Contrast
+C+C
( Post-Contrast )( Post-Contrast )
by:Mahiby:Mahi
ArterialArterial PrePre
( Befor +c )( Befor +c )
 Dynamic post ( after Inject ) contrast T1 .Dynamic post ( after Inject ) contrast T1 .
by:Mahiby:Mahi
- Delayed- Delayed Porto-venousPorto-venous
by:Mahiby:Mahi
The Sequences +CThe Sequences +C
 Axial T1Axial T1
(Arterial - Porto venous - Delayed )(Arterial - Porto venous - Delayed )
 Coronal T1Coronal T1
( Porto venous )( Porto venous )
by:Mahiby:Mahi
3
4
5
6
T2WI
by:Mahiby:Mahi
3
4
5
6
T1WI
by:Mahiby:Mahi
ERCP normal
biliary tract
Bile duct systemBile duct system
by:Mahiby:Mahi
MRCP
by:Mahiby:Mahi
Pancreas
by:Mahiby:Mahi
tail of pancreas body of pancreas
head of pancreas
MR T1WI
by:Mahiby:Mahi
head of pancreas
by:Mahiby:Mahi
T2T2 FAT SATFAT SAT
pancreas pancreatic duct
by:Mahiby:Mahi
Pancreatic headPancreatic head
head of pancreas
Portal veingallbladder
by:Mahiby:Mahi
Hepatic cyst
 CCongenital diseaseongenital disease
MRMR
 Very low signal intensity on T1WI and very highVery low signal intensity on T1WI and very high
intensity on T2WIintensity on T2WI
by:Mahiby:Mahi
MR appearance Hepatic cyst
by:Mahiby:Mahi
Thank You Very Much
by:Mahiby:Mahi

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Liver radiology MRI

  • 1. Kazan StateKazan State Medical UniversityMedical University Department of radiologyDepartment of radiology Liver, bile duct, pancreas and spleen
  • 2. Overview of the abdomenOverview of the abdomen by:Mahiby:Mahi
  • 3. And hereAnd here, we are about to describe one of the most, we are about to describe one of the most important organ in the abdominal region.important organ in the abdominal region. The liverThe liver The liver is a large,The liver is a large, meaty organ that sitsmeaty organ that sits on the right side of theon the right side of the Abdomen . WeighingAbdomen . Weighing about 3 pounds, theabout 3 pounds, the liver is reddish-brown inliver is reddish-brown in color and feels rubberycolor and feels rubbery to the touchto the touch by:Mahiby:Mahi
  • 5. Liver segments and lobulesLiver segments and lobules The liver has two largeThe liver has two large sections, called the rightsections, called the right and the left lobes.and the left lobes. And also consist of eightAnd also consist of eight segments.segments. The first segment isThe first segment is cuadatecuadate The right contain 4The right contain 4 segmentssegments The left are 3 segments .The left are 3 segments . Diagram showing the segments by:Mahiby:Mahi
  • 6. liver’s functionliver’s function The liver's main job is to filterThe liver's main job is to filter the blood coming from thethe blood coming from the digestive tract, before passing itdigestive tract, before passing it to the rest of the body.to the rest of the body. The liver also detoxifiesThe liver also detoxifies chemicals and metabolizeschemicals and metabolizes drugs. As it does so, the liverdrugs. As it does so, the liver secretes bile that ends up backsecretes bile that ends up back in the intestines. The liver alsoin the intestines. The liver also makes proteins important formakes proteins important for blood clotting and otherblood clotting and other functions.functions. by:Mahiby:Mahi
  • 7. Blood supply and venousBlood supply and venous drainagedrainage The blood supply of the liverThe blood supply of the liver is delivered through theis delivered through the portal veinportal vein and theand the hepatichepatic arteryartery. The. The hepatic arteryhepatic artery brings oxygenated blood tobrings oxygenated blood to the hepatic tissues, while thethe hepatic tissues, while the portal vein collects theportal vein collects the deoxygenated blood from thedeoxygenated blood from the abdominal contents and filtersabdominal contents and filters it, eliminating toxins andit, eliminating toxins and processing the nutrientsprocessing the nutrients TheThe hepatic portal systemhepatic portal system is the system ofis the system of veinsveins comprising thecomprising the hepatic portal veinhepatic portal vein and itsand its tributaries. It is also called thetributaries. It is also called the portal venous system.portal venous system. by:Mahiby:Mahi
  • 8. Diagram for the vascularDiagram for the vascular system of liversystem of liver by:Mahiby:Mahi
  • 9. Biliary tractBiliary tract RIGHT AND LEFT HEPATIC DUCTSRIGHT AND LEFT HEPATIC DUCTS MERGES TO FORM THEMERGES TO FORM THE COMMONCOMMON HEPATIC DUCTHEPATIC DUCT COMMON HEPATIC DUCTCOMMON HEPATIC DUCT LEAVEAS THELEAVEAS THE LIVER AND GOINING TOLIVER AND GOINING TO CYSTIC DUCTCYSTIC DUCT TO FORM THETO FORM THE COMMON BILE DUCTCOMMON BILE DUCT FINALLY DRAIN INTOFINALLY DRAIN INTO THE DOEDENUMTHE DOEDENUMby:Mahiby:Mahi
  • 10. And nowAnd now;; it’s time to discoverit’s time to discover how your abdomen looks likehow your abdomen looks like inside thisinside this Tunnel.Tunnel. by:Mahiby:Mahi
  • 11. MRIMRI 1.MRI1.MRI plain scan :: SSequence————axialaxial 、、 coronalcoronal T1WT1W 、、 T2WT2W FIESTAFIESTA 、、 DWIDWI 、、 double echodouble echo 2. MRI2. MRI enhancement scanning 3.3. MRMRAA 4.4. MRCPMRCP Magnetic Resonance Cholangiopancreatography by:Mahiby:Mahi
  • 12. 1. CORONAL PLANES1. CORONAL PLANES by:Mahiby:Mahi
  • 16.  PositioningPositioning  Position the patient in supine position with head pointingPosition the patient in supine position with head pointing towards the magnet (head first supine) .towards the magnet (head first supine) .  Position the patient over the spine coil and place the body coilPosition the patient over the spine coil and place the body coil over the upper abdomen (nipple down to iliac crest) .over the upper abdomen (nipple down to iliac crest) .  Securely tighten the body coil using straps to preventSecurely tighten the body coil using straps to prevent respiratory artefacts .respiratory artefacts .  Give a pillow under the head and cushions under the legs forGive a pillow under the head and cushions under the legs for extra comfort .extra comfort .  Centre the laser beam localizer over xiphoid process ofCentre the laser beam localizer over xiphoid process of sternum .sternum . by:Mahiby:Mahi
  • 18. 3 Survey ( Scout ) .3 Survey ( Scout ) . by:Mahiby:Mahi
  • 19. Coronal - Axial - SagittalCoronal - Axial - Sagittal by:Mahiby:Mahi
  • 20. The Sequences Before Inject TheThe Sequences Before Inject The ContrastContrast ( Pre-Contrast )( Pre-Contrast )
  • 21. 1- Axial ( T2 – T1 – *T2 Heavy )1- Axial ( T2 – T1 – *T2 Heavy ) by:Mahiby:Mahi
  • 22. Plan the Axial slices on the Coronal plane ; * angle the position block across the liver as shown. * Check the positioning block in the other two planes. * Slices must be sufficient to cover the whole liver from the diaphragm down to the iliac crest by:Mahiby:Mahi
  • 23. 2- Coronal ( T2 – T1 )2- Coronal ( T2 – T1 ) by:Mahiby:Mahi
  • 24. Plan the coronal slices on the axial image;Plan the coronal slices on the axial image; * position the block across the liver as shown.* position the block across the liver as shown. * Check in the other two planes , Slices must be sufficient to cover the* Check in the other two planes , Slices must be sufficient to cover the whole liver from the anterior abdominal wall to the posterior abdominalwhole liver from the anterior abdominal wall to the posterior abdominal wall .wall . by:Mahiby:Mahi
  • 25. The Sequences After Inject The ContrastThe Sequences After Inject The Contrast +C+C ( Post-Contrast )( Post-Contrast )
  • 27. ArterialArterial PrePre ( Befor +c )( Befor +c )  Dynamic post ( after Inject ) contrast T1 .Dynamic post ( after Inject ) contrast T1 . by:Mahiby:Mahi
  • 28. - Delayed- Delayed Porto-venousPorto-venous by:Mahiby:Mahi
  • 29. The Sequences +CThe Sequences +C  Axial T1Axial T1 (Arterial - Porto venous - Delayed )(Arterial - Porto venous - Delayed )  Coronal T1Coronal T1 ( Porto venous )( Porto venous ) by:Mahiby:Mahi
  • 32. ERCP normal biliary tract Bile duct systemBile duct system by:Mahiby:Mahi
  • 35. tail of pancreas body of pancreas head of pancreas MR T1WI by:Mahiby:Mahi
  • 37. T2T2 FAT SATFAT SAT pancreas pancreatic duct by:Mahiby:Mahi
  • 38. Pancreatic headPancreatic head head of pancreas Portal veingallbladder by:Mahiby:Mahi
  • 39. Hepatic cyst  CCongenital diseaseongenital disease MRMR  Very low signal intensity on T1WI and very highVery low signal intensity on T1WI and very high intensity on T2WIintensity on T2WI by:Mahiby:Mahi
  • 40. MR appearance Hepatic cyst by:Mahiby:Mahi
  • 41. Thank You Very Much by:Mahiby:Mahi