MR Brain Pre DBS - GPI Neuro Protocol

Scan notes:

  • All Pre- DBS exams are ordered with anxiolytics.  Radiology RNs are to evaluate the patient if you note that the patient cannot hold still.
  • If the target isn’t specified in the order for pre-DBS, contact the RDO to verify if the “GPI” or “STN” or "VIM" protocol should be used.
  • Send all images to PACS
  • No charge for the 3D Recon. 
  • A 3D T1 AX is always performed with a DTI.

Last updated:3/21/19
Charge as: Brain WO
Scanner preference: 3T only
Coil: Head

GPI INSTRUCTIONS

POSITIONING
Positioning is very important in obtaining a study that fuses.  If the patient is laying with the head going too far backwards, it is important to raise the head so the chin is down. The head coil can be tilted or a sponge can be used under the patients head. This allows for better coverage.

  • OK to use padding and headphones for all DBS patients.
  • No angles on any sequences

COVERAGE
Slices should be from top of vertex to as low as you can go.  You need to be below the acoustic nerves for best outcome. If the GPI sequence is too low, Neurosurgery might need to cancel the surgery to obtain a new scan.

RAD TO CHECK IMAGES BEFORE PATIENT LEAVES THE DEPARTMENT
All Pre-DBS exams need to be checked by a Radiologist before the patient leaves the MRI department. 
You must then page Dr. Burchiel, Anne Mitchell, and Antonia Gragg :  Format – Patient last name, GPI, VIM or STM for study type, and the Radiologist comment (Pass or fail).  If it fails, the patient needs to remain in department (add to page that patient is waiting).  We are required to reschedule the patient with GA using a callback.

Plane Weighting Mode Slice Gap FAT SAT FOV Notes
AXIAL 3D T1 FFE None 26cm DO NOT ANGLE. Cover above the vertex of the brain at least 1 cm. Cover the nose.
AXIAL (GPI) MPRAGE 3D ISO ISO None DO NOT CHANGE DO NOT ANGLE. FULL BRAIN COVERAGE. SEE NOTES FOR INSTRUCTIONS ON POSITIONING, COVERAGE AND HOW TO GET THE IMAGES CHECKED.
(Only if requested) AXIAL DTI 2 0 None 26cm DO NOT ANGLE. Cover the Entire Brain. No need for extra coverage like for stereotactic sequences.

A Radiologist or neurosurgery must check images before letting patient go.