MR Perineal Fistula W/WO Protocol

Scan Notes:

  • Void before exam
  • No need to call the radiologist for planning the Obliques
  • Send ADC maps

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: 4/12/19
Charge as: Pelvis W/WO
Scanner preference: 1.5T or 3T
Coil: Torso Coil

Plane Weighting Mode Slice Gap FAT SAT FOV Notes
COR T2 SSTSE BH 5mm 0.5mm N top of kidneys to pelvis Scan sacrum to anterior abdominal wall. CONFIRM GOOD COIL PLACEMENT. Large FOV to include kidneys. Pelvic pathology is often related to renal pathology
SAG T2 TSE 2.5mm 0mm N 24mm, fit to patient Mid-femoral head to mid-femoral head. Freq A-P. Consider using an anterior Sat band if lots of abdominal wall motion. Use to plan oblique planes.
AX Oblique T1 TSE 4mm 0.8mm N 20-24mm, fit to patient Freq A-P to avoid bowel motion ghosting into uterus and bladder. Plan slices axial to the anal canal.
AX Oblique T2 TSE 4mm 0.8mm N 20-24mm, fit to patient Freq A-P to avoid bowel motion ghosting into uterus and bladder. Plan slices axial to the anal canal.
AX Oblique T2 TSE FS 4mm 0.8mm Y 20-24mm, fit to patient Same parameters as AX OBLIQUE T1 TSE. Freq A-P to avoid bowel motion ghosting into uterus and bladder. Plan slices axial to the anal canal.
COR Oblique T2 TSE FS 4mm 0.8mm Y 20-24mm, fit to patient Freq A-P. Plan slices coronal to the anal canal.
Axial T2 VISTA-FS Y 20-24mm, fit to patient Scan from Iliac crest to butt cheeks. If the scan time becomes too long, decrease scan range, but the lower rectum, anus, and perineum must be included. Please do if on 3T.
AX Oblique T1 3D thrive high resolution pre Y Match AX OBLIQUE T2 TSE HIGH RESOLUTION THRIVEs. Same parameters as AX OBLIQUE T2 TSE.

Contrast injection-hand inject

Plane Weighting Mode Slice Gap FAT SAT FOV Notes
SAG T1 3D thrive post- BH Y Medial femoral head to medial femoral head
AX Oblique T1 3D thrive high resolution post-contrast Y Match AX Oblique TSE T2 HIGH RESOLUTION THRIVEs. Match parameters as AX OBLIQUE HI-RES THRIVE pre-contrast.
COR Oblique T1 3D thrive high resolution post-contrast BH Y Match COR Oblique TSE FS T2 Match COR Oblique TSE FS T2
AX Oblique T2 DWI 5mm 1mm SPIR Match AX Oblique TSE T2 Trigger & track. Free-breathing sequence, so please position slices accordingly. B=0, 500, 1000.
MR Adult Perineal Fistula WWO Protocol image