Magnetic resonance imaging (MRI) is known for its superior ability to diagnose pathology of the abdomen due to its intrinsically high contrast. MRI is also increasingly used in the diagnosis of acute pancreatitis. There is now strong evidence that non-enhanced MRI is as effective as contrast-enhanced computed tomography in assessing the severity of acute pancreatitis. In addition, in patients presenting with malignant hypertension, MR angiography has emerged as an exquisitely sensitive modality for the diagnosis of renal artery stenosis. Despite the wide range of possible applications of MRI, there are several limitations that prevent its use in a wide range of patients. MRI scans take a significant amount of time, and the risk of an unstable patient decompensating during the scan far outweighs the possible benefits of the imaging. Patients selected for MRI must be able to lie still for the duration of the scan to prevent movement artifacts.

The progress made by transitioning from axial imaging of soft tissue (with single-detector Computed Tomography (CT) scanners) to volumetric imaging (by multidetector CTs (MDCTs)) has revolutionized vascular studies. CT angiography (CTA) of the abdomen can truly alter management and dispositions. Leaking or dissecting abdominal aortas, along with similar lesions in the iliac vessels, are among the most anxiety-provoking diagnoses for the emergency medicine physician. The search for the cause of intractable chronic hypertension often includes a study to determine whether renal artery stenosis is present. CTA is well-suited to this task. CTA has been shown to be useful in both arterial and venous occlusion in the mesenteric circulation, and to demonstrate whether bowel injury from vascular compromise is present. Data acquisition of thrombus in the inferior vena cava (IVC) or its contributaries from the pelvis and proximal lower extremities can be useful in guiding therapy regarding thrombolysis versus stent placement.