Thursday February 23 , 2012
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Protocols - MRI

 General Guidelines:

  • Everything that is post-contrast should have a pre-contrast with the exact same settings (TR, TE, Flip angle, etc...)

  • CANCER BEING CONSIDERED:  should have at least one conventional T1 instead of FSE.  This give more signal intensity for bone marrow and shows metastases more conspicuously.

 

Brain W/O

3 PL LOC

23 SECS

ASSET CAL

12 SECS

SAG T1

3-4 MINS

AX DWI

56 SECS

AX FRFSE T2

1-2 MINS

AX T2 FLAIR

3-4 MINS

AX T1

2-3 MINS

AX T2 GRE

4-5 MINS

 

Brain W & W/O

3 PL LOC

23 SECS

ASSET CAL

12 SECS

SAG T1

3-4 MINS

AX DWI

56 SECS

AX FRFSE T2

1-2 MINS

AX T2 FLAIR

3-4 MINS

AX T1

2-3 MINS

AX T2 GRE

4-5 MINS

AX T1 POST

3-4 MINS

COR T1 POST

3-4 MINS

 

Brain - Internal Auditory Canals

3 PL LOC

23 SECS

ASSET CAL

12 SECS

SAG T1

3-4 MINS

AX DWI

56 SECS

AX FRFSE T2

1-2 MINS

AX T2 3MM

4-5 MINS

AX T1 3MM

5-6 MINS

AX T1 3MM POST

5-6 MINS

COR T1 MM POST

5-6 MINS

AX T1 POST

3-4 MINS

L-Spine W/O

3 PL LOC

23 SECS

COR T2

2-3 MINS

SAG T1

4-5 MINS

SAG T2

2-3 MINS

SAG IR

3-4 MINS

AX T2

3-4 MINS

L-Spine W & W/O

3 PL LOC

23 SECS

COR T2

2-3 MINS

SAG T1

4-5 MINS

SAG T2

2-3 MINS

SAG IR

3-4 MINS

SAG T1 F/S

4-5 MINS

AX T2

3-4 MINS

SAG T1 F/S POST

4-5 MINS

AX T1 POST

5-6 MINS

 

Orbits

3 PL LOC

23 SECS

ASSET CAL

12 SECS

SAG T1

3-4 MINS

AX DWI

56 SECS

AX FRFSE T2

1-2 MINS

AX T2 3MM

4-5 MINS

AX T1 3MM

5-6 MINS

COR T1

4-5 MINS

COR T1 POST

4-5 MINS

AX T1 3MM

5-6 MINS

AX T1 POST

3-4 MINS

 

MRA Brain

3 PL LOC

23 SECS

3D TOF 2 SLABS

6-7 MINS

 

PIT

3 PL LOC

23 SECS

ASSET CAL

12 SECS

SAG T1

3-4 MINS

AX DWI

56 SECS

AX FRFSE T2

1-2 MINS

COR T1 3MM

3-4 MINS

SAG T1 3MM

3-4 MINS

SAG T1 3MM POST

3-4 MINS

COR T1 3MM POST

3-4 MINS

AX T1 POST

3-4 MINS

 

C-Spine W/O

3 PL LOC

23 SECS

COR T2

2-3 MINS

SAG T1

4-5 MINS

SAG T2

2-3 MINS

SAG IR

3-4 MINS

AX T2

3-4 MINS

AX GRE

4-5 MINS

 

 

C-Spine W & W/O

3 PL LOC

23 SECS

COR T2

2-3 MINS

SAG T1

4-5 MINS

SAG T2

2-3 MINS

SAG IR

3-4 MINS

SAG T1 F/S

4-5 MINS

AX T2

3-4 MINS

AX GRE

4-5 MINS

AX T2

3-4 MINS

SAG T1 F/S POST

4-5 MINS

AX T1 POST

5-6 MINS

 

T-Spine W/O

3 PL LOC

23 SECS

COR T2

2-3 MINS

SAG T1

4-5 MINS

SAG T2

2-3 MINS

SAG IR

3-4 MINS

AX T2

3-4 MINS

 

T-Spine W & W/O

3 PL LOC

23 SECS

COR T2

2-3 MINS

SAG T1

4-5 MINS

SAG T2

2-3 MINS

SAG IR

3-4 MINS

SAG T1 F/S

4-5 MINS

AX T2

3-4 MINS

SAG T1 F/S POST

4-5 MINS

AX T1 POST

5-6 MINS

 

 

Pelvis W/O

3 PL LOC

23 SECS

AX T2

5-6 MINS

AX T1 F/S

7-8 MINS

COR T2

6-7 MINS

COR T1

6-7 MINS

SAG T2

3-4 MINS

 

Pelvis W & W/O

3 PL LOC

23 SECS

AX T2

5-6 MINS

AX T1 F/S

7-8 MINS

COR T2

6-7 MINS

COR T1

6-7 MINS

SAG T2

3-4 MINS

AX T1 F/S POST

7-8 MINS

COR T1 F/S POST

7-8 MINS

 

Neck W/O

3 PL LOC

23 SECS

SAG T1

3-4 MINS

SAG T2

3-4 MINS

AX T2

4-5 MINS

AX T1

7-8 MINS

COR T1 F/S

5-6 MINS

COR IR

7-8 MINS

 

Neck  W & W/O

3 PL LOC

23 SECS

SAG T1

3-4 MINS

SAG T2

3-4 MINS

AX T2

4-5 MINS

AX T1

7-8 MINS

COR T1 F/S

5-6 MINS

COR IR

7-8 MINS

COR T1 F/S POST

4-5 MINS

AX T1 F/S POST

8-9 MINS

 

Abdomen W & W/O

3 PL LOC

23 SECS

ASSET CAL

23 SECS

COR T2 SSFSE

20-30 SECS

AX DE FSPGR

30-40 SECS

AX T1 FSPGR O/P F/S

1-2 MINS

AX T2 FRFSE F/S

1-2 MINS

AX T2 SSFSE

30-45 SECS

AX T1 FAME

25-30 SECS

AX T1 FAME MULTI-PHASE POST

1-2 MINS

COR FSPGR POST

25-30 SECS

 

MRCP

3 PL LOC

23 SECS

ASSET CAL

23 SECS

COR T2 SSFSE

20-30 SECS

AX T2 SSFSE

20-30 SECS

AX T2 FRFSE F/S

1-2 MINS

3D MRCP RT R

8-9 MINS

THICK SLAB

1-2 MINS

THIN SLAB

1-2 MINS

AX T1 FSPGR F/S

1-2 MINS

AX DUAL ECHO FSPGR

1-2 MINS

 

Sciatic Nerve MRI

Sciatic Nerve Anatomy - Anterior View & Posterior View

lumbosacral-plexus-anterior-viewsciatic-nerve-posterior-view

  • Axial T1.  FOV  L3 through below greater trochanter

sciatic-neurogram-axial-t1

  • Sagittal Oblique T2 Fat-Saturated.  FOV  L3 through below greater trochanter

sciatic-neurogram-sag-oblique

  • Coronal T2 Fat-Saturated.  FOV 3cm anterior to vertebral body to 3 cm posterior to greater trochanter.

sciatic-neurogram-coronal-t2-fatsat

  • Coronal STIR:  same field of view

sciatic-neurogram-coronal-STIR

 

Shoulder

3 PL LOC

23 SECS

AX T2* GRE

6-7 MINS

COR T2 F/S

4-5 MINS

COR PD

3-4 MINS

COR IR

6-7 MINS

SAG T1

4-5 MINS

SAG PD F/S

3-4 MINS

 

Pelvis/Hip

3 PL LOC

23 SECS

COR T1

5-6 MINS

COR IR

4-5 MINS

AX T2 F/S BILAT

4-5 MINS

AX PD BILAT

4-5 MINS

SAG T2 F/S

2-3 MINS

COR PD UNI

2-3 MINS

 

Knee

3 PL LOC

23 SECS

AX T2* GRE

5-6 MINS

SAG PD F/S

3-4 MINS

SAG PD

3-4 MINS

COR T1

5-6 MINS

COR PD F/S

5-6 MINS

 

Ankle W/O

3 PL LOC

23 SECS

AX PD

3-4 MINS

AX T2 F/S

4-5 MINS

SAG IR

4-5 MINS

SAG T1

4-5 MINS

COR PD F/S

5-6 MINS

 

Ankle W  & W/O

3 PL LOC

23 SECS

AX PD

3-4 MINS

AX T2 F/S

4-5 MINS

AX T1 F/S

4-5 MINS

SAG IR

4-5 MINS

SAG T1

4-5 MINS

COR PD F/S

5-6 MINS

AX T1 F/S POST

4-5 MINS

COR T1 POST

3-4 MINS

 

Wrist

3 PL LOC

23 SECS

COR T2* GRE

3-4 MINS

COR T1

3-4 MINS

AX PD

3-4 MINS

AX T2* GRE

3-4 MINS

SAG PD F/S

2-3 MINS

SAG T2 F/S

2-3 MINS

AX T2 F/S

3-4 MINS

T1 3D FSPGR

4-5 MINS

 

Foot W/O

3 PL LOC

23 SECS

AX PD

5-6 MINS

AX T2 F/F

4-5 MINS

COR T2 F/S

4-5 MINS

COR T1

4-5 MINS

SAG IR

4-5 MINS

SAG PD

3-4 MINS

 

FOOT W & W/O

3 PL LOC

23 SECS

AX PD

5-6 MINS

AX T2 F/F

4-5 MINS

AX T1 F/S

4-5 MINS

COR T2 F/S

4-5 MINS

COR T1

4-5 MINS

SAG IR

4-5 MINS

SAG PD

3-4 MINS

AX T1 F/S POST

4-5 MINS

COR T1 POST

4-5 MINS

 

Elbow

3 PL LOC

23 SECS

AX T1

3-4 MINS

AX PD F/S

3-4 MINS

COR T1

3-4 MINS

COR IR

4-5 MINS

SAG T1

3-4 MINS

SAG IR

4-5 MINS

 

Brachial Plexus W & W/O

3 PL LOC

23 SECS

COR T1

6-7 MINS

COR T2

3-4 MINS

SAG T2

4-5 MINS

AX T1

7-8 MINS

AX T2

2-3 MINS

AX T1 F/S POST

10-11 MINS

COR T1 F/S POST

13-14 MINS

 

C-SPINE W/O

  • 3 PL LOC                                23 SECS

  • COR T2                                2-3 MINS

  • SAG T1                                                   4-5 MINS

  • SAG T2                                2-3 MINS

  • SAG IR                                3-4 MINS

  • AX T2                                3-4 MINS

  • AX GRE                                              4-5 MINS

 

 

C-SPINE W & W/O

  • 3 PL LOC                            23 SECS

  • COR T2                                2-3 MINS

  • SAG T1                                4-5 MINS

  • SAG T2                                  2-3 MINS

  • SAG IR                             3-4 MINS

  • SAG T1 F/S                                4-5 MINS

  • AX T2                                3-4 MINS

  • AX GRE                                           4-5 MINS

  • AX T2                             3-4 MINS

  • SAG T1 F/S POST                        4-5 MINS

  • AX T1 POST                                5-6 MINS

 

 

T-SPINE W/O

  • 3 PL LOC                            23 SECS

  • COR T2                             2-3 MINS

  • SAG T1                                4-5 MINS

  • SAG T2                                2-3 MINS

  • SAG IR                                3-4 MINS

  • AX T2                             3-4 MINS

 

 

T-SPINE W & W/O

3 PL LOC                                23 SECS

COR T2                                2 -3 MINS

SAG T1                             4-5 MINS

SAG T2                                   2-3 MINS

SAG IR                                3-4 MINS

SAG T1 F/S                            4-5 MINS

AX T2                                3-4 MINS

SAG T1 F/S POST                   4-5 MINS

AX T1 POST                              5-6 MINS

 

 

L-SPINE W/O

3 PL LOC                            23 SECS

COR T2                                2-3 MINS

SAG T1                                4-5 MINS

SAG T2                                           2-3 MINS

SAG IR                                3-4 MINS

AX T2                                3-4 MINS

 

L-SPINE W & W/O

3 PL LOC                                23 SECS

COR T2                                           2-3 MINS

SAG T1                             4-5 MINS

SAG T2                             2-3 MINS

SAG IR                             3-4 MINS

SAG T1 F/S                                4-5 MINS

AX T2                             3-4 MINS

SAG T1 F/S POST                        4-5 MINS

AX T1 POST                                5-6 MINS

 

 

PELVIS W/O

3 PL LOC                                23 SECS

AX T2                                 5-6 MINS

AX T1 F/S                                7-8 MINS

COR T2                                6-7 MINS

COR T1                             6-7 MINS

SAG T2                                          3-4 MINS 

 

PELVIS W & W/O

3 PL LOC                                23 SECS

AX T2                             5-6 MINS

AX T1 F/S                                7-8 MINS

COR T2                                       6-7 MINS

COR T1                                6-7 MINS

SAG T2                             3-4 MINS

AX T1 F/S POST                              7-8 MINS

COR T1 F/S POST                           7-8 MINS

 

NECK W/O

3 PL LO                                23 SECS

SAG T1                             3-4 MINS

SAG T2                             3-4 MINS

AX T2                                4-5 MINS

AX T1                                7-8 MINS

COR T1 F/S                            5-6 MINS

COR  IR                                7-8 MINS 

 

NECK W & W/O

3 PL LOC                                                   23 SECS

SAG T1                             3-4 MINS

SAG T2                             3-4 MINS

AX T2                                4-5 MINS

AX T1                                     7-8 MINS

COR T1 F/S                                5-6 MINS

COR  IR                                7-8 MINS

COR T1 F/S POST                           4-5 MINS

AX T1 F/S POST                                8-9 MINS 

ABDOMEN W & W/O

3 PL LOC                            23 SECS

ASSET CAL                                23 SECS

COR T2 SSFSE                                20-30 SECS

AX DE FSPGR                                30-40 SECS

AX T1 FSPGR O/P F/S                                                        1-2 MINS

AX T2 FRFSE F/S                                                           1-2 MINS

AX T2 SSFSE                                30-45 SECS

AX T1 FAME                           25-30 SECS

AX T1 FAME MULTI-PHASE POST                               1-2 MINS

COR FSPGR POST                                25-30 SECS 

MRCP

3 PL LOC                            23 SECS

ASSET CAL                                23 SECS

COR T2 SSFSE                                20-30 SECS

AX T2 SSFSE                                                20-30 SECS

AX T2 FRFSE F/S                            1-2 MINS

3D MRCP RT R                                8-9 MINS

THICK SLAB                                  1-2 MINS

THIN SLAB                           1-2 MINS

AX T1 FSPGR F/S                                1-2 MINS

AX DUAL ECHO FSPGR                                1-2 MINS

 

 

SHOULDER

3 PL LOC                                23 SECS

AX T2* GRE                                6-7 MINS

COR T2 F/S                            4-5 MINS

COR PD                                3-4 MINS

COR IR                                6-7 MINS

SAG T1                                4-5 MINS

SAG PD F/S                                3-4 MINS 

 

PELVIS/HIP

3 PL LOC                                23 SECS

COR T1                                5-6 MINS

COR IR                             4-5 MINS

AX T2 F/S BILAT                                4-5 MINS

AX PD BILAT                                                   4-5 MINS

SAG T2 F/S                                2-3 MINS

COR PD UNI                            2-3 MINS 

KNEE

3 PL LOC                                23 SECS

AX T2 * GRE                                5-6 MINS

SAG PD F/S                                3-4 MINS

SAG PD                                3-4 MINS

COR T1                                              5-6 MINS

COR PD F/S                            5-6 MINS 


ANKLE W/O

3 PL LOC                                23 SECS

AX PD                             3-4 MINS

AX T2 F/S                                4-5 MINS

SAG IR                             4-5 MINS

SAG T1                                4-5 MINS

COR PD F/S                                            5-6 MINS 

ANKLE W & W/O

3 PL LOC                                23 SECS

AX PD                             3-4 MINS

AX T2 F/S                                                        4-5 MINS

AX T1 F/S                            4-5 MINS

SAG IR                                4-5 MINS

SAG T1                                4-5 MINS

COR PD F/S                                5-6 MINS

AX T1 F/S POST                           4-5 MINS

COR T1 POST                                3-4 MINS 



WRIST

3 PL LOC                                          23 SECS

COR T2* GRE                            3-4 MINS

COR T1                                3-4 MINS

AX PD                                3-4 MINS

AX T2 * GRE                            3-4 MINS

SAG PD F/S                            2-3 MINS

SAG T2 F/S                                2-3 MINS

AX T2 F/S                            3-4 MINS

T1 3D FSPGR                          4-5 MINS 

FOOT W/O

3 PL LOC                                23 SECS

AX PD                                5-6 MINS

AX T2 F/F                                                     4-5 MINS

COR T2 F/S                            4-5 MINS

COR T1                                4-5 MINS

SAG IR                                4-5 MINS

SAG PD                                3-4 MINS 

FOOT W & W/O

3 PL LOC                                23 SECS

AX PD                                5-6 MINS

AX T2 F/F                                4-5 MINS

AX T1 F/S                                4-5 MINS

COR T2 F/S                                4-5 MINS

COR T1                                          4-5 MINS

SAG IR                                4-5 MINS

SAG PD                                3-4 MINS

AX T1 F/S POST                                4-5 MINS

COR T1 POST                                4-5 MINS 

ELBOW

3 PL LOC                                23 SECS

AX T1                             3-4 MINS

AX PD F/S                            3-4 MINS

COR T1                             3-4 MINS

COR IR                                                 4-5 MINS

SAG T1                             3-4 MINS

SAG IR                             4-5 MINS 



BRACHIAL PLEXUS W & W/O

3 PL LOC                                         23 SECS

COR T1                             6-7 MINS

COR T2                             3-4 MINS

SAG T2                             4-5 MINS

AX T1                             7-8 MINS

AX T2                             2-3 MINS

AX T1 F/S POST                           10-11 MINS

COR T1 F/S POST                           13-14 MINS

 




MR ABDOMEN:

  • Localizer

  • Asset Cal BH - Don't need to send to PACS

  • Coronal T2 SSFSE BH

  • Axial FSPGR BH

  • Axial T1 FSPGR O/P FS

  • Ax T2 FRFSE BH FS

  • Ax T2 SSFSE BH

  • Ax FAME T1 BH Pre, 2.5 mm

  • Ax FAME T1 BH Multiphase, 2.5 mm (Coming out very grainy), 350 images, Acc 45008

  • Cor FSPGR 3D BH, 2 mm

MR ABDOMEN - MRCP

  • 3D MRCP RTrAsset comes out nice

  • Screen save, thin slab, thick slab MRCP are not coming out well.  2009.02.12; Accession #2658


MR BRACHIAL PLEXUS:

  • AX T1, 3MM

  • AX T2, 3MM

  • COR T1, 3MM

  • COR T2, 3MM

  • AX T1 FS, POST-CONTRAST, 3MM

  • COR T1 FS, POST-CONTRAST, 3MM

MRI Brain W & W/O:

  • Localizer

  • Asset  Cal

  • Sag T1 Sl Th 5 mm Slice 1.5

  • O/Ax DWI   Sl Th 5 mm Slice 1.5

  • AX FRFSE T2  Sl Th 5 mm Slice 1.5

  • AX T2 FLAIR  Sl Th 5 mm Slice 1.5

  • AX T1 SE Sl Th 5 mm Slice 1.5

  • AX T2* GRE (TRAUMA –BLEED) Sl Th 5 mm Slice 1.5

  • IF POST-CONTRAST, ADD THESE:

  • AX T1 SE +C Sl Th 5 mm Slice 1.5

  • COR T1 SE +C Sl Th 5 mm Slice 1.5


MR Elbow:

  • Cor T1

  • Cor T2 FS (Poor spatial resolution; maybe switch to STIR)

  • Sag T1

  • Sag T2 FS (Poor spatial resolution; maybe switch to STIR)

  • Ax T1 SE


MR Foot:

 

  • Make sure the entire foot from calcaneus to distal phalanges are in the field of view

  • Axial PD FSE, 4mm, 2.0 min

  • Axi T2 FS, 4mm, 2.0 min

  • Sag T1 FSE, 3.5, 3.5 min

  • Sag STIR, 3.5 mm, 4.0 min

  • Coronal PD FS, 4 mm, 2.3 min

  • Tarsal Tunnel View (perpendicular to tarsal tunnel) PD, 3 mm, 2.5 min

MR Hip

  • If they only order one hip, you should try to get high resolution images of that one side.  Don't need both sides.

  • Axial FSE PD—4MM-1:45

  • Axial FSE PD FS-4MM—1:45

  • Cor T1 SE-4MM-4MIN (both hips)

  • Cor STIR-4MM-4:14 (both hips)

  • Sag FSE PD FS-4MM-1:45

  • Sag FSE T1, High ResolutioN-4MM-1:30

  • Ax FSE T1 OPT, High Resolution-5MM-5:15

MRA Lower Extremities:

  • 3D TOP TE MINIMUM FLIP ANGLE 30 TIME 17 SEC

  • 3D MID TE MINIMUM FLIP ANGLE 30 TIME 16 SEC

  • 3D BOTTOM TE MINIMUM FLIP ANGLE 30 TIME 1:06

MR Knee

  • Sag T1, 4mm

  • Sag T2, 4mm

  • Sag STIR, 4mm

  • Axial T2, 4mm

  • Axial GRE T2*, 4mm

MR Pelvis

  • Localizer (3-plane), 27i

  • Localizer (3-plane), 27i

  • T2 SSFSE BH (coronal), 28i

  • T2 FrFSE (coronal), 30i

  • T2 FSE (sagittal), 24i

  • T1 FSPGRE FS O/P (axial), 31i - edge artifact is not there.  was this done right?

  • T1 FSPGRE FS I/P (axial), 31i

  • T2 FRFSE BH FS (axial), 31i

  • Obl FSE parallel/perp to uterus can be thrown out.

  • T1 FSE (coronal), 28i

  • CANCER BEING CONSIDERED:  should have atleast one conventional T1 instead of FSE.  This give more signal intensity for bone marrow and shows metastases more conspicuously.

  • CONTRAST:

    • T1 FSPGR FS GD (axial), 33i

    • T1 FSPGR FS GD (coronal), 33i

    • T1 FSPGR FS GD (sagittal), 33i - aren't post-contrast the past phases? can throw out sagittal one.

 

MR Shoulder

  • axial PD FSE fatSat, 4.0 mm; (2.5 min)

  • Cor T2 FatSat; 4.0 mm, 4.0 mm; (3.0 min)

  • Coronal PD FSE, 4.0 mm; (2.5 min)

  • Coronal T2, 4.0 mm; (?)

  • Sag T2 FatSat, 4.0 mm; (3.0 min)

MR Spine - All parts

  • For cancer or bone lesions, include a sagittal T1 SE (Note FSE).  The FSE does not have enough T1 intensity for bone marrow.
  • For post-contrast studies, do the precontrast using the exact same scan parameters.

MR SPINE, CERVICAL

  • sag T1---2MIN. 3MM
  • sag T2---2 ½ MIN 3MM
  • sag STIR---3 ½ MIN 3MM
  • axial T2---4MIN 3MM
  • axial GRE (T2*)---6MIN 3MM -----////4MM=5MIN    ////  5MM=3 1/2MIN
  • For cancer or bone lesions, include a sagittal T1 SE (NOT FSE).  The FSE does not have enough T1 intensity for bone marrow.
  • Post Contrast Patients Add: T1 Fat-Sat Sagittal Pre/Post with same TR/TE and flip

For questions, please contact a local radiologist or a teleradiologist.