Abdominal MRI (without contrast)

What it is

MRI does something CT cannot: it distinguishes tissue by what the tissue is made of. Fat, water, iron, and fresh blood each behave differently in a magnetic field, and the scan can be tuned to pick out one of them. That is why an abdominal MRI is frequently a second scan rather than a first — an ultrasound or a CT finds a spot on the liver or the adrenal gland, cannot say what it is, and MRI is asked to settle it. This code is the version with no dye injected. Skipping the gadolinium means the study cannot show how a lesion's blood supply behaves, but for a great many abdominal questions the tissue signal alone is the answer.

Why it is done

• To decide whether a spot found on another scan is a simple cyst, a fat-containing benign nodule, or something that needs more work
• To estimate how much fat or iron has built up in the liver, which MRI can measure without a biopsy
• To follow a known benign finding over time, where repeated dye exposure is unattractive and the shape and signal are all that need checking
• To image the abdomen in someone whose kidney function or allergy history makes gadolinium unappealing
• To look at the kidneys, adrenal glands, spleen, or pancreas when radiation from repeated CT is a concern

What to expect

There is no IV and no dye, though many centers ask for a few hours of fasting so the bowel and gallbladder are quiet. Metal comes off and implants are declared. The patient lies on their back and slides into the bore, and much of the exam is run in breath-holds — a recorded voice asks for a breath in and a hold of ten to twenty seconds, repeated many times. That is the part patients usually find tiring. The scan generally takes thirty to forty-five minutes. Nothing afterward is restricted. A radiologist reads the images and issues a report, typically within a few days.

Questions worth asking

• Is there a chance a contrast series gets added on the day of the scan? That converts this into a different, more expensive code, so ask who decides and when.
• Is an MRCP — the bile and pancreatic duct sequence — included in the order? It is billed under its own code, not as part of this one.
• What is the price at a freestanding imaging center versus the hospital department? Abdominal MRI is one of the scans where that gap tends to be largest.
• Will the radiologist's reading come as a separate professional fee, and is that group contracted with my plan?
• If a prior CT or ultrasound is what prompted this, can those images be sent over so a comparison does not require repeating anything?