MR Pancreas W/WO with MRCP BODY and Secretin Protocol - Adult and Peds

Last updated: 1/31/2024
Charge as: Abdomen and MRCP WWO
Scanner preference: 1.5T or 3T
Coil: Torso Coil
Contrast: Charge for Gadolinium and Secretin

Patient Prep:

  • Patient to be NPO x 4 hours

Secretin Instructions:

  • Secretin dose: 16 micrograms IV given over 1 minute, administered by RN
  • RN to give test dose 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.
MRI Abd Pre Post Subtraction
Please check images to ensure contrast is present and subtractions have been generated. Manually generate subtractions if needed.
Plane Weighting Mode Slice Gap FAT SAT FOV Notes
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.
Power Inject Contrast Bolus Track Trigger when bolus reaches the SMA
Axial T1 3D mDixon x3 phases BH - - Y Entire liver Exact parameters as the pre-mDixon.
COR T1 3D mDixon 3 min post - - Yes Cover diaphragm to aortic bifurcation, abdominal wall to abdominal wall Perform @ 3 minutes post contrast
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 INSTRUCTIONS
1. RN gives test dose prior to scanning
2. RN gives Secretin 16 micrograms IV given over 1 minute while scanning.
3. Tech: Begin Dynamic COR T2 MRCP at the start of Secretin injection (baseline image)
4. Scan every 30 seconds for 10 minutes
COR with Secretin T2 MRCP 40mm - Y Center on pancreas. Include duodenum and entire pancreas Begin scan and inject secretin at the same time. Coordinate timing with RN.
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