Abdominal Radiology includes extensive programs in patient care, teaching and research. In addition, the division offers a fellowship in abdominal computed tomography, abdominal magnetic resonance and ultrasound as part of a combined Cross-sectional Imaging Fellowship.
CT, GI and GU
Abdominal Computed Tomography (CT) is based in modern, well-equipped facilities at the University of Michigan Hospitals, East Ann Arbor and Canton facilities.
A total of 9 scanners are housed at these UMHS sites. This includes four 64-slice multidetector (MDCT) scanners and five other MDCT machines. One of these CT scanners is situated within our Emergency Department. A high volume of clinical and research work is generated by these 9 CT scanners.
The radiologists of the Abdominal CT subdivision, in addition to interpreting standard examinations of the abdomen and pelvis for detection of the full spectrum of inflammatory and neoplastic conditions, is at the forefront of development and evaluation of cutting edge advances in CT technology. Some of the advanced techniques developed and now used on a daily basis include 3D CT angiography for a variety of vascular diseases including evaluation of abdominal aortic aneurysms for stent graft placement, CT Enterography and CT Urography. Multiphasic imaging of pancreatic and hepatic neoplasms, and CT densitometry for differentiating benign from malignant adrenal masses are also key clinical areas of expertise. Clinical and research activities are key components of our body CT section.
A free-standing advanced 3D post processing lab with 4 staff aids the clinical, research and teaching mission of the CT section. Several free-standing advanced workstations are available in this area, in addition to the four workstations present in the abdominal CT reading area.
The Gastrointestinal (GI) 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 endoscopic retrograde cholangiopancreatography (ERCP) studies is provided.
The Genitourinary (GU) Radiology subdivision performs the standard contrast examinations, including excretory urography, cystography, voiding cystourethography and retrograde urethography. Hysterosalpingography is performed in conjunction with faculty from the Department of Obstetrics and Gynecology, with the images interpreted by radiologists in the Abdominal Division.
Clinical fellows, as part of the Cross-sectional Fellowship, play a major role in the abdominal CT section. Fellows spend their time learning the underlying principles and clinical application of MDCT necessary to optimally prescribe and interpret CT images and participate in research projects. Fellows work side by side on a daily basis with leaders within the CT field as evidenced by the numerous faculty who are members of the Society of Computed Body Tomography and Magnetic Resonance (SCBTMR), Society of Gastrointestinal Radiology (SGR) and Society of Uroradiology (SUR).
The Cross-sectional Interventional Division provides a wide range of image-guided diagnostic and therapeutic procedures that often are alternatives to surgery. The primary imaging treatments used as guidance for these procedures are ultrasonography and computed tomography. Cross-sectional Interventional radiologists are highly trained in imaging and performance of these medical procedures while minimizing patient discomfort.
This clinical service comprises six physicians and two physician assistants. Clinical volume is approximately 2,400 procedures annually, including:
- botulism toxin injection for spastic paralysis
- catheter placement for drainage of infected fluid collections
- core or fine needle biopsies
- diagnostic and therapeutic fluid aspirations
- percutaneous and intraoperative radiofrequency and cryoablations of liver and renal masses (offered to patients as treatment of unresectable primary or metastatic liver and renal cancer)
- treatment of catheter-induced pseudo-aneurysms with thrombin injection
Consultations also are provided for difficult abdominal and pelvic cases needing image-guided procedures.
The division is equipped with cutting-edge technology. And the broad-based experience of our team provides an updated approach to image-guided procedures. We are committed to maintaining the highest standards of care.
Magnetic Resonance Imaging
Magnetic Resonance Imaging is based in modern, well-equipped facilities at the University of Michigan Hospitals, Mott Children and Women’s, Brighton, Northville, and East Ann Arbor facilities.
Scanners include four 1.5T Philips systems at our offsite facilities, three Philips scanners at Mott (1.0T, 1.5T, 3.0T), and seven scanners at the main hospital. The main hospital scanners include Siemens (two 3T) and Philips (1.0T, two 1.5T, and two 3.0T). One of the 3.0T scanners at the main hospital is dedicated to clinical research. All of the scanners include advanced pulse sequences, including echo planar, functional MR, MR angiography, quantitative imaging, and spectroscopy. In addition, additional magnets are dedicated to basic research, including one 2.0T animal imager and a 7.0T small bore system.
The abdominal MR subdivision provides a full range of MR examinations of the abdomen and pelvis. The University of Michigan Hospital is a leader in liver diseases, liver transplantation, prostate imaging, renal imaging, bowel imaging, and gynecological imaging. High resolution 3D Magnetic Resonance Cholangiopancreatography (MRCP) studies of the biliary and pancreatic ducts are performed. Multiparametric prostate MR is performed for prostate cancer detection, staging, and targeting. MR enterography for the evaluation of Crohn's disease and other gastrointestinal diseases are performed. In conjunction with the Cardiovascular and Interventional Radiology Division, the Abdominal Division performs and interprets the MR angiography studies of the abdominal, pelvic and lower extremity vasculature. Characterization of known or suspected uterine anomalies is commonly performed. All of the clinical MR scanners are state-of-the-art 1.5 and 3 Tesla units.
Faculty in the MR subdivision participate in multispecialty tumor boards including liver, GI, GU, pancreas, adrenal, and many others.
Our facility is unique in providing state-of-the-art clinical magnetic resonance imaging in an attractive and state-of-the-art hospital setting, closely coupled with a superb basic science program dealing with all aspects of magnetic resonance imaging, contrast agent development, and data image processing.
In our extensive research program, we perform research studies using uniquely developed, innovative pulse sequences for spectroscopy, vascular imaging, diffusion / perfusion imaging, and functional MR. Full-time research physicists specialize in MRI as part of our faculty; in addition, a full-time Philips scientist develops and optimizes sequences for the clinical and research Philips scanners.
Fellows spend most of their time learning the underlying principles and clinical application of MRI necessary to optimally prescribe and interpret MR images and participate in research projects.
Ultrasound provides in-depth training in the performance and interpretation of obstetrical, gynecological (including sonohysterograms), small parts, pelvic, other vascular imaging using Doppler and color Doppler, and abdominal ultrasound exams. Extensive experience in ultrasound-guided procedures, transvaginal and prostate scanning is also provided. Full-time, nationally-recognized faculty members closely supervise the fellow. We encourage participation in ongoing clinical and/or basic research. General ultrasound services are offered at eight different sites throughout the surrounding regional area as well as 4 campus locations. A dedicated staff of over 60 sonographers perform over 70,000 ultrasound examinations annually. Equipment consists of 25 real-time scanners, all with Doppler and shearwave elastography capabilities. Two procedural machines have direct rf access, and two have real-time 3-D capabilities.
Bi-monthly ultrasound teaching conferences are held throughout the year. In addition, every year the University holds five post-graduate courses, including sonography.