Patient Care

The Abdominal Division of the Department of Radiology offers a full range of imaging services to evaluate known or suspected disorders of the abdomen and pelvis. The Division is subdivided into four separate subdivisions: Gastrointestinal Radiology, Genitourinary Radiology, Abdominal Computed Tomography (CT) and Abdominal Magnetic Resonance Imaging (MR).

The Gastrointestinal Radiology subdivision provides the standard examinations for contrast evaluation of the gastrointestinal tract, including double contrast and biphasic techniques, enteroclysis and per-oral pneumocolon examinations. Three phase pharyngograms for swallowing disorders and defecography for incontinence are also performed. Interpretation of all ERCP studies is provided.

The Genitourinary Radiology subdivision performs the standard contrast examinations including excretory urography, cystography, voiding cystourethography and retrograde urethography. All hysterosalpingography is performed in conjunction with faculty from the Department of Obstetrics and Gynecology and the images are interpreted by the Abdominal Division.

The Abdominal CT subdivision, in addition to performing standard examinations of the abdomen and pelvis for detection of the full spectrum of inflammatory and neoplastic conditions, is in the forefront of development and evaluation of cutting edge advances in CT technology. The six current CT scanners use the helical technology, including two with the newest multidetector-row platform. Some of the advanced techniques developed and now used on a daily basis include 3D CT angiography for renal transplant donors and evaluation of abdominal aortic aneurysms for stent graft placement, multiphasic imaging of pancreatic and hepatic neoplasms, and CT densitometry for differentiating benign from malignant adrenal masses.

The abdominal MR subdivision provides a full range of MR examinations of the abdomen and pelvis including standard evaluation of known or suspected masses in the liver, spleen, pancreas, adrenal glands and kidneys. Characterization of known or suspected uterine anomalies is commonly performed. MRCP studies of the biliary and pancreatic ducts and MR urography are a growing part of our MR activities. In conjunction with the Cardiovascular and Interventional Radiology Division, the Abdominal Division performs and interprets the MR angiography studies of the abdominal and pelvic vasculature. All of the clinical MR scanners are state-of-the-art 1.5 Tesla units.

Teaching

Teaching is an inseparable component of the activities of the Abdominal Radiology Division. The division is responsible for teaching of radiology residents, medical students and post-residency Fellows. One or more Radiology residents are assigned to each of the four subdivisions on a weekly basis. The residents routinely monitor all of the examinations performed in the Gastrointestinal, Genitourinary, and Abdominal MR subdivision, and then preview nearly all of these studies and those in the Abdominal CT subdivision prior to review and discussion with the assigned faculty radiologist.

Medical students choosing a Radiology elective typically rotate through the Abdominal Division where they observe procedures being performed and participate in the interpretation sessions that occur at the view boxes multiple times during the day. The students also attend the two separate 45 minute teaching sessions held daily which are given by the attending Radiology faculty including those from the Abdominal Division.

At these designated teaching sessions material is presented in either a didactic or an unknown-case format, or a combination of the two. Although these daily formal teaching conferences are designed primarily for the radiology residents, medical students taking a radiology elective are also in attendance. The Abdominal Division faculty presents four of these teaching sessions each month.

Along with the Ultrasound Division and the Abdominal MR subdivision, the Abdominal CT subdivision participates in the cross-sectional imaging Fellowship. One or more cross-sectional Fellows rotate through the Abdominal CT area several months during the year, and instruction of the Fellow is an important aspect of the overall teaching responsibility of this subdivision. During their first few weeks on the CT rotation, the Fellow typically reviews many or all of the cases with an attending faculty, but the Fellow then gradually increases the number of cases viewed independently as his/her experience and confidence increases.

Research

Members of the Abdominal Division are actively involved in research investigations. Focus of these research activities varies widely, but some of the current and recent activities have taken advantage of our department having access to one of the first multidetector-row CT scanners placed in an academic center. Studies with this newest advance in CT technology have included 1) refined multiphasic contrast-enhanced scanning of pancreatic and hepatic neoplasms, 2) improved resolution of 3D CT angiographic studies of the abdominal vasculature, 3) virtual cystoscopy, and 4) development of new techniques for the burgeoning field of helical CT urography using high-resolution 3D reformatted images of the entire urinary tract. Other research has included studies on differentiating adrenal adenomas from nonadenomas using unenhanced and early delayed CT attenuation values, critical evaluation of the accepted diagnostic signs used to differentiate ureteral calculi from pelvic phleboliths on helical CT, and optimizing the use of digital CT scout abdomen images for simplified follow-up of ureteral calculi detected on helical CT.

The division of Magnetic Resonance Imaging is based in modern, well-equipped facilities at the University of Michigan Hospitals and the Ann Arbor Veterans Administration Medical Center. Four General Electric Horizon Systems operate at a field strength of 1.5 Tesla and include advanced pulse sequences, echo planar, functional MR, MR/Angiography, and spectroscopy. In addition, located in a building near the University Hospital, there are additional magnets dedicated to research, including a 2.0 Tesla animal imager and both a 7.0 and a 9.4 Testa small bore system. There is a Data Image Processing Laboratory, which is involved in research with image processing of digital data for ultrasound, CT and MR.