MR Female Pelvis for Endometriosis WWO BODY Protocol
Notes
Last updated: 3/25/2021
Charge as: Pelvis WWO
Scanner preference: MR2, MR3, MR1 only
Coil: Torso Coil
Exam Notes
- This exam requires special patient prep.
- The patients have to be scheduled with a Rad RN.
- Rad RN: will assist with vaginal gel insertion and will also be giving glucagon for this exam.
- The MRI techs: rectal gel insertion while the RNs are prepping the glucagon.
- Exam time from patient arrival to exit is approximately 2 hours
- Scan time is 60-75 minutes
- Male and Female MRI techs to perform the exam unless patient states a preference
Patient Prep
- NPO for 4 hours prior
- Do Not Void within 1 hour of scan.
Gel Insertion and Glucagon
- Rad Rn will be placing intra-vaginal ultrasound gel while on MR table, using enema tip on 60cc syringe.
- Rad Rn to place gel-filled syringe tip deep, close to cervix, filling vagina with gel while slowly removing syringe. Goal is to fill the vaginal vault completely near cervix with gel containing as little air as possible.
- Rectal ultrasound gel 60-180 mL placed by MR tech.
Glucagon 1 mg IV JUST AFTER SCOUTS. Perform 3-plane T2 TSE immediately after injection.
Post-Processing
- Reformats of 3D T2 at 1 mm to coronal and sagittal planes.
- Subtractions
- ADC map
| Plane | Weighting | MODE | SLICE | GAP | FS | FOV | SCAN RANGE | Notes |
|---|---|---|---|---|---|---|---|---|
| SAG | T2 | TSE/HI-RES | 4 mm | 0.4 mm | No | Small FOV | Fem Head to Fem Head | Include female pelvis anatomy. Anterior Sat Band. Matrix 512 x 256. NSA 2 |
| AX | T2 | TSE/HI-RES | 4 mm | 0.4 mm | No | 200-240 mm/ Fit to Patient | Cover female anatomy | Matrix 448 x 291. NSA 2 |
| COR | T2 | TSE/HI-RES | 4 mm | 0.4 mm | No | 200-240 mm/Fit to Patient | Minimize to female anatomy | At least 250 phase-encoding steps. |
| AX | T2 | 3D TSE | 2 mm | -- | No | 270 mm/ Fit to Patient | Minimize to female anatomy | Do not reduce slices; SNR is dependent on 3D volume. 2 mm slice interpolated to 1 mm. Anterior Sat Band. Reformat other 2 planes at 1 mm. |
| AX | T2 | DWI | 5 mm | 1 mm | SPIR | Manually create ADC Map | Trigger & track.B=0, 500, 800. | |
| Ax | T1 | In/Out Dixon | 5 mm | 0 mm | No | 200-240 mm/ Fit to Patient | Minimize to relevant anatomy | To be done if mDixons canВ’t be separated into in and out of phases |
| AX | T1 | 3D mDixon pre | -- | -- | Yes | 200-240mm/Fit to Patient | Ao bifurc to symphysis | HIGH RESOLUTION mDixon. Separate into fat only, water only, in and out of phase. |
| SAG | T1 | 3D mDixon pre | -- | -- | Yes | Small FOV | HIGH RESOLUTION mDixon | |
| Hand Inject Contrast | ||||||||
| SAG | T1 | 3D mDixon post | -- | -- | Yes | Exact same as pre | Perform Subtractions. | HIGH RESOLUTION mDixon. |
| AX | T1 | 3D mDixon post | -- | -- | Yes | Exact same as pre | Perform Subtractions. | HIGH RESOLUTION mDixon. |
| COR | T2 | SSTSE | 5 mm | 1 mm | No | Large | Include kidneys |