MR Pediatric Enterography WWO Protocol

Scan Notes:   
- Patient Prep: The patient can continue to drink liquids but should not have solid food from 4 hours before the exam.
- Patient prone if able
- Images must be checked by radiologist or radiology resident before giving contrast and before the patient gets off the table. 
- Make screenshot of amount of Volumen and glucagon was given and send to Pacs.

Last updated:3/28/19
Charge as: Abdomen W/WO, and Pelvis W/WO
Scanner preference: 1.5T or 3T
Coil: Torso or Cardiac
Contrast: Gad and Glucagon

Volumen

Amount the patient needs to drink is 20 mL/kg, up to but not exceeding 1800 mL. The nurse will prepare this contrast. If this is for an inpatient, VIP the contrast to the floor with drinking instructions attached.
The rad nurse (or floor nurse if for an inpatient) will give the contrast to the patient.
Patient must start drinking 90 min before study, finishing 15 min before imaging.
The nurse will tell you when the patient started drinking so you can prepare to have the scanner available. If this is for an inpatient, tell them what time to have the patient start drinking.

Gadolinium

    Patient will receive gad, dosed by weight.
    This is not a dynamic study, so you don’t have to load the power injector.
    Contrast is given immediately after 2nd dose of glucagon is given.

Glucagon

    Glucagon 0.5 mg IV total dose, divided into two doses.
    1st dose: Nurse gives 0.25 mg IV immediately after localizing sequences have been performed.
    2nd dose: Nurse gives second 0.25 mg IV after pediatric Radiologist checks the pre gad images. Contrast is given immediately after the 2nd glucagon dose is given.
    Charge for the glucagon

Plane Weighting Mode Slice Gap FAT SAT FOV Notes
COR T2 TSE SS BH 5mm 1mm None Fit to Patient Entire abdomen, and pelvis, skin to skin
AXIAL T1 MS FFE 5.4mm 1mm WATS (Proset) Fit to Patient Above diaphragm through pubic symphysis. Use two stacks (separate "upper" and "lower" sequences) if needed to cover a large area. You may SLIGHTLY clip the liver dome to retain one stack. Don't clip the pelvis.
AXIAL T2 TSE SS 3mm 0.5mm SPAIR Fit to Patient Above diaphragm through pubic symphysis
AXIAL 2D bTFE bTFE 5mm 0.5mm STIR Fit to Patient Entire abdomen, and pelvis, skin to skin
COR 2D bTFE bTFE 4mm (-2)mm None Fit to Patient Entire abdomen, and pelvis, skin to skin
AXIAL T2 FSE 3mm 0.5mm SPAIR Fit to Patient Pelvis ONLY, Top of iliac crests through entire perineum (to below lesser tochanters of femurs)

Contrast injection-hand inject

Plane Weighting Mode Slice Gap FAT SAT FOV Notes
AXIAL T1 MS FFE 5.4mm 1mm WATS (Proset) Fit to Patient Above diaphragm through pubic symphysis
COR T1 Thrive 3D SPAIR Fit to Patient Entire abdomen and pelvis, skin to skin
MR Pediatric Enterography WWO Protocol image