MR Pediatric Abdomen Liver Mass W/WO MRCP Protocol

Revised - 8/13/2013
Charge as Abdomen W/WO
For Liver Mass WWO Secretin see notes below
Coil: Size to patient
Localizer
(REF scan)
Mode Slice Gap FAT SAT FOV Scan Range
AXIAL T1 TSE MV MS 3.5mm 1mm None Fit to Patient Above diaphragm to iliac crests
AXIAL T2 TSE MV MS 3.5mm 1mm SPAIR Fit to Patient Above diaphragm to iliac crests
COR STIR TSE MV MS 3.5mm 1mm STIR Fit to Patient Entire abdomen, skin to skin
COR DWIBS IR EPI SS 5mm 1mm None Fit to Patient Entire abdomen, skin to skin
Axial 3D-mDixion pre 2.25eff 0mm Fit to Patient Scan Liver
COR T1 TSE MV MS 3.5mm 1mm None Fit to Patient Optional: Only if requested by a radiologist.
Entire abdomen, skin to skin
SAG STIR TSE MV MS 3.5mm 1mm STIR Fit to Patient Optional: On any patient with neuroblastoma or paraspinal mass- or if specifically requested by a radiologist.
Entire abdomen, skin to skin
Contrast Injection
AXIAL 3 phase dynamic 3D-mDixion post 2.25eff 0mm Fit to Patient Bolus trak in sagittal plane: trigger when contrast reaches SMA: 3 phases, one right after another (roughly 30, 60, 90 seconds). Scan liver.
AXIAL 3D-mDixion delayed 2.25eff 0mm Fit to Patient Exactly 4 minutes after contrast injection. Scan liver.
3D COR MRCP FRFSE XL NAV 1.4mm Fit to Patient Position slices through bottom 2/3 of liver, making sure to include pancreas.
RADIAL MRCP SSFSE Fit to Patient 12 slices at 30 degree increments. Locate pancreatic duct using axial SSFSE and center radial slices on duct. Program 1 location per pause to eliminate crosstalk between slices.
AXIAL 3D-mDixion delayed 2.25eff 0mm Fit to Patient Exactly 10 minutes after contrast injection.
Scan liver.
AXIAL T1 TSE MV MS 3.5mm 1mm SPIR Fit to Patient Above diaphragm to iliac crests
COR T1 TSE MV MS 3.5mm 1mm SPIR Fit to Patient Entire abdomen, skin to skin
SAG T1 TSE MV MS 3.5mm 1mm SPIR Fit to Patient Optional: On any patient with neuroblastoma or paraspinal mass- or if specifically requested by a radiologist.
Entire abdomen, skin to skin
Notes: For larger patients, slice thickness may be increased up to 5mm.
For dynamic sequence, patient will need a 22 gauge IV or larger. Power inject pediatric weight-based contrast dose followed by saline flush.
Please do subtractions on mDixons (subtraction = each of 3 post-contrast sequences – pre-contrast sequence).
Images must be checked by radiologist or radiology resident before patient leaves.

Liver Mass WWO Secretin

  1. This exam is basically a LIVER MASS with MRCP, so use the same protocol sequences. There is a protocol built into MR1.
  2. The MRCP is a dynamic.
  3. SECRETIN: An adult dose of 16 μg (0.2 μg/kg body weight in children) is used.
  4. At the commencement of injection, a baseline scan is obtained, followed by coronal SSFSE images (2-second scanning time) every 30 seconds for 10 minutes.
  5. In healthy subjects, the maximal effect of IV secretin is between 7–10 minutes.
  6. We prefer the use of 300 mL of proprietary silicone-coated superparamagnetic iron oxide particle suspension (ferumoxsil, GastroMark, Mallinckrodt Medical) (Fig. 1A, 1B) taken orally a few minutes before the MRI examination.