MR Dementia Brain WWO Neuro Protocol

Last updated: 6/8/2020
Charge as: Brain WWO
Scanner preference: 3T only
Coil: Head

Exam data must include: Age/DOB, Exam Date, Gender, and ID

  • Landmark at nasion/glabella (±50mm), you must re-landmark in the brain if another body part is scanned first.
  • Keep the 3D box as straight as possible.
  • No patients with shunts or major artifact-causing items.
  • Braces are usually okay, if there is not a great deal of motion, keep head tightly padded.
  • Kyphosis prop up hips not head coil.
  • Keep patient at Isocenter For patients with small heads and long necks or large heads:
    • Keep FOV box positioned higher than normal but not beyond ±50mm from glabella
    • May need to reduce/enlarge the FOV for the individual (not beyond 24 - 25.6)
    • FOV must include all of scalp, nose and chin.

Required Scan Parameters

Following parameters remain consistent:

1. Plane – sagittal
2. Mode – 3D
3. T1 weighted - Always
4. Matrix – 192 x 192
5. NEX / NSA – 1
6. Slice thickness – 1.2 mm
7. Spacing – 1.2 mm
8. Number of slices – 160 - 170
9. FOV 24 – 25.6

NOTE: Some NeuroQuant parameters vary depending on scanner manufacturer & field strength

NeuroQuant Failures (And How to Avoid Them)

Patient Motion

  • Run NeuroQuant sagittal 3D first
  • Pad head securely
  • Use all motion reduction techniques except changing scan parameters

Artifacts

  • Surgical resections, shunts, metal (some are not compatible)
  • Incompatible with NeuroQuant
  • Tumors > 15cc
  • Contrast media - scan Non Contrast

Low SNR

  • Follow recommended scan parameters

Tissue contrast Error

  • Put saline bags on either side of patient's head
  • Sat bands
  • Follow recommended scan parameters

Incorrect landmark

  • Must landmark at nasion/glabella
  • Can be ± 50mm from Nasion - should be as close as possible in all 3 planes
  • Re - landmark, if C-spine was done first as part of a double study

Network Issue

  • Echo test failure – call your network admin
  • Resend series
  • Error report “Series is missing slices”

Unsupported MR Sequence

  • Delete incorrect series from queue monitor
  • Resend Sag 3D T1 series
Plane Weighting Mode Slice Gap FAT SAT FOV Notes
SAG 3DT1 FFE 1mm. Maximum 170 slices 0.5mm None 23cm Maximum 170 slices. Scalp to Scalp- 3DT1 series must be pushed to 3 places: NQ_AGE_ATROPHY, NQ_MULTISTRUCTURE, NQ_TRIAGE_BRAIN
SAG 3DFLAIR TSE 3mm 0.3mm None 23cm Scalp to Scalp- use high res from MS protocol and reconstruct to 3/0.3 slice/gap. Coverage beyond the ears to avoid wrap.
MPR FLAIR and 3DT1 Make coronal and axial from both 3D sequences.
AXIAL T2 TSE 3mm 0.3mm None 23cm Angle to Corpus- Skull Base to Vertex
AXIAL T2*GRE GRE 4mm 1mm None 23cm Angle to Corpus- Skull Base to Vertex
AXIAL VEN BOLD 3D FFE 2mm 0mm None 23cm 124 Slices MAX- Skull Base to Vertex
AXIAL SW 36/30 3D FFE 2mm 0mm None 23cm 124 Slices MAX- Skull Base to Vertex
AXIAL DWI 2mm Voxel SE EPI 3mm 0.3mm SPIR 23cm Angle to Corpus- Skull Base to Vertex

Contrast injection

Plane Weighting Mode Slice Gap FAT SAT FOV Notes
AXIAL T1 TSE 3mm 0.3mm None 23cm Angle to Corpus- Skull Base to Vertex
COR T1 TSE 3mm 0.3mm None 23cm Frontal through Occipital Bone