MR Pancreas W/WO with MRCP BODY and Secretin Protocol

  • Patient to be NPO x 4 hours
  • Negative PO contrast (pineapple juice + Gd) to be given right before the patient gets on table.
  • Secretin 16 micrograms IV given over 1 minute
    • Test dose to be given prior to scanning
    • Begin Dynamic MRCP at the start of injection (baseline image)
    • Scan every 30 seconds for 10 minutes
  • FOV: do not include patient’s arms
  • AJR.2010;195:42-53. 

Breath holds:

  • Scan on expiration.
  • Monitor that patient is breath-holding. Breathe the patient slowly so they have time to follow instructions. Do not start scan until the patient has stopped breathing.
  • Give 2L O2 if it will help with breath-holds UNLESS PATIENT HAS COPD OR ANOTHER REASON NOT TO GIVE O2.

Last updated: 6/26/19
Charge as: Abdomen and MRCP WWO
Scanner preference: 1.5T or 3T
Coil: Torso Coil
Contrast: Charge for Gad and Secretin

Negative PO contrast (pineapple juice + Gd) to be given right before the patient gets on table.

Plane Weighting Mode Slice Gap FAT SAT FOV Notes
Give PO Contrast before exam start Negative PO contrast (pineapple juice + Gd) to be given right before the patient gets on table.
Cor T2 SSFSE BH 7mm 1mm N Liver through bottom of kidneys Ensure Pancreas is well-centered in coil to ensure good signal at dome.
Axial T1 Dual Echo SPGR BH 7mm 1mm N Entire liver May be separated into overlapping stacks if patient cannot breath-hold. Do not interleave images. No SENSE.
Axial T2 bTFE BH 4mm -2mm N Include WHOLE pancreas, esp uncinated and tail. No SENSE.
Axial T1 3D mDixon pre BH - - Y Entire liver Perform 3 overlapping stacks. Do not interleave.

Contrast injection

Bolus Track. Trigger when bolus reaches SMA.

Plane Weighting Mode Slice Gap FAT SAT FOV Notes
Axial T1 3D mDixon x3 phases BH - - Y Entire liver Exact parameters as the pre-mDixon.
Axial T1 3D mDixon BH - - Y Entire liver Timed exactly 4 mins post-injection.
Axial T2 TSE RT 5mm 0.5mm SPAIR Entire liver Okay to use 6mm slice thickness with 1mm gap on MR1 and CHMR2.
Cor T2 3D MRCP 1.4mm Y Bottom 2/3 of liver through bottom of pancreas Please use navigator trigger & track.
Cor T2 Radial MRCP 12mm Y Liver through bottom of kidneys Please use navigator trigger & track. 12Slices @ ~30 degree intervals.
Axial T2 DWI 7mm 1mm SPIR Liver through bottom of kidneys Trigger & Track

Secretin injection

  • RN gives test dose to be given prior to scanning
  • RN gives Secretin 16 micrograms IV given over 1 minute while scanning. 
  • Tech: Begin Dynamic MRCP at the start of Secretin injection (baseline image)
  • Scan every 30 seconds for 10 minutes
Plane Weighting Mode Slice Gap FAT SAT FOV Notes
COR with Secretin T2 MRCP 40mm - Y Center over pancreas Dynamic imaging with Secretin. include duodenum and pancreas.
MR Adult Liver Mass WWO BODY Protocol image
MR Abdomen and Pelvis WWO BODY Protocol image
MR Adult Pancreas WWO with MRCP BODY Protocol image