MRI (without Contrast) Vs CT With Contrast For Abdomen

[Seph]

We have made an MRI of the lower and upper abdomen of my mother in November 2017 and October 2018. We paid for these privately because we wanted to limit radiation exposure. I believe having a CT scan of the abdomen with contrast is comparatively one of the tests with the highest level of radiation. My mother has an auto-immune disease CIDP and is already at higher risk of developing something worse. We try everything to keep her healthy; anti-inflammatory diet/supplements and exercise.

The doctor at the hospital now says a CT scan with contrast of the abdomen is needed because the MRI did not have enough detail. I thought MRI scans were generally more detailed than CT scans. She has fluid retention that is likely caused by a thrombosis of the portal vein (that has been present for 1.5-2 years). The MRI did not give any indication of other problems. My question is whether we can do an MRI that is as detailed as a 'CT with contrast' for identifying possible problems like cancer. This seems unlikely however because of the result of the MRI's (absence of much change for the last year, only more fluit retention).

 

[Lurker]

I would get a second opinion on the previous scan before any more scans are done.

 

[Seph]

Are MRI's not suited for diagnosing the organs in the upper abdomen like the liver? I know bowels cannot be seen due to movement. Are there no non-radiological tests that can be used like Echo or more focused MRI or even MRI with contrast? Are CT-scans with contrast the only way to rule out cancer?

 

[aguilaroja]

We have made an MRI of the lower and upper abdomen of my mother in November 2017 and October 2018.

The doctor at the hospital now says a CT scan with contrast of the abdomen is needed because the MRI did not have enough detail....She has fluid retention that is likely caused by a thrombosis of the portal vein (that has been present for 1.5-2 years). The MRI did not give any indication of other problems... (absence of much change for the last year, only more fluit retention).

There are at least a couple of forum members with direct experience in radiology. Perhaps they will comment. First, it possible in many places to ask a radiologist, as a free courtesy, to review previous films. This can be done by a neutral radiologist, in a different workplace.

The hospital doctor can be asked what few possibilities the differential list, and how getting the proposed CT would change decision making and treatment.

There are no perfect tests in medicine. MRI and CT, when done well, even without contrast, each show a lot of detail. The emphasis is visualizing tissue is a bit different. If there were no limits on safety, cost, time, and comfort, extra testing sometimes gives extra perspective. In the real world, habit and cost usually factor in more than safety.

This article discusses portal vein thrombosis:
Portal vein thrombosis | Radiology Reference Article | Radiopaedia.org
Colour Doppler ultrasound is one possibility to evaluate for tumor thrombus, without ionizing radiation. If the ultrasound suggests thrombus due to tumor, the hospital doctor may insist on abdominal CT anyway.

If, for instance, the doctor is suspecting HCC, the diagnosis has been visualized by MRI & Ultrasound.
Hepatocellular carcinoma | Radiology Reference Article | Radiopaedia.org

Search the forum for posts about protective measures for X-ray procedures, if your mother goes through with the Abdomen CT.

 

[Seph]

That is great info.

Does a CT scan of the abdomen always include the upper and lower abdomen? Is only a CT scan of the upper abdomen (including the liver) a possibility to reduce radiation?

Nothing on the MRI scans suggests tumors, especially since the organs look about the same as in 2017. Would there not be obvious changes in the MRI from November 2017 with the one from Oktober 2018 if there were serious problems with one of the organs in the upper belly in that timeframe? She has CIDP which is an autoimmune neuropathy, she developed two years ago. But the first subtle symptoms started even sooner maybe 2.5 or 3 years ago. I know autoimmune diseases are sometimes triggered by cancer, but the time frame and the negative results of the MRI scans (without contrast) does not really indicate this. Only the fluid in abdomen increased, but that is most logically explained by the porta vena Thrombosis. She has always been lean and muscular and still is. She has a stable weight). Only her under belly is a bit bloated but not extremely either, it's not hard bloated.

The hospital just wants to make sure and wants to exclude the possibility of tumors, but I really do not like the risk of radiation exposure (especially with a CT of the abdomen). They have a different view because they want the fastest and easiest test to exclude it. And the risks are statistically low. I always tried to keep her healthy with an anti-inflammatory diet, low carb, fasting, vegetables and berries, curcumin and all sorts of supplements. And she exercises as much as possible.

Search the forum for posts about protective measures for X-ray procedures, if your mother goes through with the Abdomen CT.

I can't really find that, could you post some links too. I suspect it's about drinking a lot of water and also taking antioxidants?

 

[aguilaroja]

...I suspect it's about drinking a lot of water and also taking antioxidants?

Perhaps there is not familiarity with Dr. Peat's ideas. The low carb (if no fruit sugar), hydration, fasting, berry intake measures do not sound particularly coinciding with Dr. Peat's ideas. You can also search his site:
raypeat.com
and the resource search and links mentioned here:
PeatSearch: a Ray Peat-specific search engine - Toxinless

Niacinamide and red (wavelength) light are two of the things mentioned by Dr. Peat. I don't recall every notion mentioned on the forum, and don't necessarily agree with all suggestions. It is better for you to search directly.
Radiation From X-rays - Just How Dangerous?
Nutritional Protection For X-rays?

 

[Seph]

Does a CT scan of the abdomen always include the upper and lower abdomen? Is only a CT scan of the upper abdomen (including the liver) a possibility to reduce radiation?

 

[aguilaroja]

Does a CT scan of the abdomen always include the upper and lower abdomen? Is only a CT scan of the upper abdomen (including the liver) a possibility to reduce radiation?

A specific question to the decision-makers involved is probably required. Every nation, region, health network, hospital, specialty, and even equipment manufacturer has their own dogma/protocol, though many are similar. I cannot say if it is possible or if a group is willing to reduce a CT scanning region area on request. When inquiring many times about family, no radiology worker has ever acknowledged that radiation may be significantly dangerous. The most they say is that "new" equipment is "much safer".

 

[Rinse & rePeat]

Killer CT SCANS

"Now, people who don’t want x-rays are treated as crackpots. Probably because of this cultural situation, Gofman’s recommendations are very mild--simply for doctors to use good technology and to know what they are doing, which could lead to ten-fold or even hundred-fold dose reduction. Even with...

raypeatforum.com