Presentation
Infected peripancreatic necrosis with duodenal fistula for investigation, delineation of anatomy. Endoscopy done 2/12 ago, 2 x endo clips placed at greater gastric curve post-biopsy.
Patient Data
Magnetic susceptibility artifact is seen from two endoscopic clips (COR, AX) at the greater gastric curvature.
Note: When there is suspicion of a susceptibility artifact potentially obscuring an anatomy of interest, radiographers are encouraged to perform an AX T1 sequence as soon as possible. Such artifacts are most prominent in this particular sequence, and upon reviewing with the department's radiologist, will help determine if the rest of the protocol should continue, or whether the scan should be aborted.
Case Discussion
This scan was aborted once it was determined that the endoscopic clips causing magnetic susceptibility artifact would continue to yield non-diagnostic images and decrease the value of the examination.
These images serve as a reminder that endoscopic clips can present as large susceptibility artifacts on MRI and depending on their location, may or may not obscure the anatomy of interest. Endoscopic clips are found to detach naturally within two weeks of deployment, although studies have shown their retention for up to two years 1 (note: an abdominal x-ray is a quick way to determine its presence prior to rescheduling an MRI).
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