MR Pediatric Liver Mass MRCP WWO or with Secretin Protocol
Scan Notes
Last updated: 11/4/2020
Charge as: Abdomen W/WO with MRCP
Scanner preference: 1.5T or 3T
Coil: Torso or Cardiac
Contrast: Gad (and Secretin if ordered)
Images must be checked by peds radiologist before giving contrast and before the patient gets off the table.
If ordered as Liver Mass WWO Secretin:
- This exam is basically a LIVER MASS with MRCP, so use the same protocol sequences.
- There is a protocol built into MR1.
- The MRCP is a dynamic.
SECRETIN:
- An adult dose of 16 μg (0.2 μg/kg body weight in children) is used.
- At the commencement of injection, a baseline scan is obtained, followed by coronal SSFSE images (2-second scanning time) every 30 seconds for 10 minutes.
- In healthy subjects, the maximal effect of IV secretin is between 7–10 minutes.
- Body rads prefer the use of 300 mL of proprietary silicone-coated superparamagnetic iron oxide particle suspension (ferumoxsil, GastroMark, Mallinckrodt Medical) (Fig. 1A, 1B) taken orally a few minutes before the MRI examination.
Plane | Weighting | Mode | Slice | Gap | FAT SAT | FOV | Notes |
---|---|---|---|---|---|---|---|
AXIAL | T1 | TSE MV MS | 3.5mm | 1mm | None | Fit to Patient | Above diaphragm to iliac crests |
AXIAL | T2 | TSE MV MS | 3.5mm | 1mm | SPAIR | Fit to Patient | Above diaphragm to iliac crests |
COR | STIR | TSE MV MS | 3.5mm | 1mm | STIR | Fit to Patient | Entire abdomen, skin to skin |
COR | DWIBS | IR EPI SS | 5mm | 1mm | None | Fit to Patient | Entire abdomen, skin to skin |
Axial | 3D-mDixion | pre | 2.25eff | Fit to Patient | Scan Liver | ||
COR | T1 | TSE MV MS | 3.5mm | 1mm | None | Fit to Patient | Optional: Only if requested by a radiologist.Entire abdomen, skin to skin |
SAG | STIR | TSE MV MS | 3.5mm | 1mm | STIR | Fit to Patient | Optional: On any patient with neuroblastoma or paraspinal mass - or if requested by a radiologist.Entire abdomen, skin to skin |
Contrast injection
Power Inject: Bolus trak in sagittal plane: trigger when contrast reaches SMA
Plane | Weighting | Mode | Slice | Gap | FAT SAT | FOV | Notes |
---|---|---|---|---|---|---|---|
AXIAL | 3 phase dynamic 3D-mDixon | post | 2.25eff | Fit to Patient | Bolus trak in sagittal plane: trigger when contrast reaches SMA: 3 phases, one right after another (roughly 30, 60, 90 seconds).Scan liver. | ||
AXIAL | 3D-mDixon | delayed | 2.25eff | Fit to Patient | Exactly 4 minutes after contrast injection.Scan liver. | ||
AXIAL | T1 | TSE MV MS | 3.5mm | 1mm | SPIR | Fit to Patient | Above diaphragm to iliac crests |
COR | T1 | TSE MV MS | 3.5mm | 1mm | SPIR | Fit to Patient | Entire abdomen, skin to skin |
AXIAL | 3D-mDixon | delayed | 2.25eff | Fit to Patient | Exactly 10 minutes after contrast injection.Scan liver. | ||
SAG | T1 | TSE MV MS | 3.5mm | 1mm | SPIR | Fit to Patient | Optional: On any patient with neuroblastoma or paraspinal mass- or if specifically requested by a radiologist.Entire abdomen, skin to skin |