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MR Imaging of Acute Right Lower Quadrant Pain in Pregnant and Nonpregnant Patients¹

¹ From the Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215. Recipient of a Cum Laude award for an education exhibit at the 2005 RSNA Annual Meeting. Received June 7, 2006; revision requested July 19 and received September 13; accepted September 14. N.M.R. receives research support from GE Healthcare (Waukesha, Wis), is on the advisory board of Berlex Laboratories (Wayne, NJ), and is a consultant to CAD Sciences (White Plains, NY); all other authors have no financial relationships to disclose. Address correspondence to I.P. (e-mail: ipedrosa{at}bidmc.harvard.edu).

The use of magnetic resonance (MR) imaging in the evaluation of acute abdominal pain is increasing, particularly in those circumstances where computed tomography (CT) is not desirable (eg, pregnancy, allergy to iodinated contrast material). Although ultrasonography (US) is considered the imaging study of choice for evaluation of abdominal pain in pregnant patients, MR imaging is a valuable adjunct to US in evaluation of pregnant patients with acute right lower quadrant (RLQ) pain who have inconclusive US results. MR imaging is also frequently used in patients with renal failure, in whom the use of iodinated contrast material is contraindicated, as well as in cases where CT results are inconclusive. In patients with acute RLQ pain, the breadth of abnormalities visible at MR imaging is very broad, with pathologic conditions potentially originating from multiple organ systems, but most commonly from the gastrointestinal and genitourinary systems. MR imaging is an excellent imaging modality for evaluation of RLQ pain and should be strongly considered in those patients in whom use of iodinated contrast media or radiation is not desirable.

© RSNA, 2007

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Invited Commentary • Authors’ Response

Douglas S. Katz, Vladimir Merunka, John J. Hines, Evan M. Meiner, Ivan Pedrosa, Deborah Levine, and Neil M. Rofsky
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