MR Pancreas W/WO with MRCP BODY and Secretin Protocol - Adult and Peds
- Patient to be NPO x 4 hours
- Give patient 1ml gad mixed in a glass of water immediately prior to putting them on the table.
- Secretin 16 micrograms IV given over 1 minute
- Test dose to be given prior to scanning
- Administered by Rn
- 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.
Last updated: 12/8/20
Charge as: Abdomen and MRCP WWO
Scanner preference: 1.5T or 3T
Coil: Torso Coil
Contrast: Charge for Gad and Secretin
Unsedated patients: Give patient 1ml gad mixed in a glass of water immediately prior to putting them on the table.
| 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. |
Contrast injection
Bolus Track. Trigger when bolus reaches SMA.
| Plane | Weighting | Mode | Slice | Gap | FAT SAT | FOV | Notes |
|---|---|---|---|---|---|---|---|
| Axial | T1 | 3D mDixon x3 phases BH | - | - | Y | Entire liver | Exact parameters as the pre-mDixon. |
| 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
- RN gives test dose to be given prior to scanning
- RN gives Secretin 16 micrograms IV given over 1 minute while scanning.
- Tech: Begin Dynamic MRCP at the start of Secretin injection (baseline image)
- Scan every 30 seconds for 10 minutes
| Plane | Weighting | Mode | Slice | Gap | FAT SAT | FOV | Notes |
|---|---|---|---|---|---|---|---|
| COR with Secretin | T2 | MRCP | 40mm | - | Y | Center over pancreas | Dynamic imaging with Secretin. include duodenum and pancreas. |
