Diagnostic Potential of Magnetic Resonance Imaging in Chronic Abdominal Pain

Dig Surg. 2020;37(3):258-264. doi: 10.1159/000502797. Epub 2019 Sep 10.


Introduction: About half of the adult patients suffering from chronic abdominal pain may have no organ-related cause. Our purpose was to evaluate the additional information of magnetic resonance imaging (MRI) in diagnosing the underlying organic causes of such pain.

Methods: We performed retrospective audit of 636 consecutive abdominal MRI in patients suffering from nonspecific abdominal pain (NSAP) during years 2014-2017. Medical history, clinical examination, endoscopy reports, and the results of MRI were compared in all patients. The hypothesis was that MRI increases markedly the diagnostic specificity of patients' symptoms.

Results: The mean age of patients was 66 ± 14 years and 60 percent were females. Duration of abdominal pain ranged from 1 month to 30 years (median 1.1 ± 4.0 years). Concurrently with abdominal MRI (n = 636), also ultrasound (n = 106, 17%), colonoscopy (n = 222, 35%), and gastroscopy (n = 217, 34%) were performed. Abdominal MRI revealed additional information in 161/636 (25%) of NSAP patients. Spinal and pelvic bone abnormalities (n = 107) and malignant tumors (n= 31) were the most significant organ-specific findings changing the treatment algorithm.

Conclusions: When computerized tomography is not available in outpatient clinics, abdominal MRI increases markedly diagnostic specificity and alters the treatment in 1 of 4 patients suffering from NSAP. Abdominal MRI is therefore suggested for patients suffering from severe symptoms of NSAP.

Keywords: Chronic abdominal pain; Diagnosis; Magnetic resonance imaging; Nonspecific abdominal pain.

MeSH terms

  • Abdominal Pain / diagnostic imaging*
  • Abdominal Pain / etiology*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Chronic Pain / diagnostic imaging*
  • Chronic Pain / etiology*
  • Diagnosis, Differential
  • Endoscopy, Gastrointestinal
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Medical History Taking
  • Middle Aged
  • Physical Examination
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Ultrasonography
  • Young Adult