- 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.
- Please do subtractions on mDixons: (subtraction = each of 3 post-contrast sequences – pre-contrast sequence).
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.
We 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.
Charge as: Abdomen W/WO with MRCP
Scanner preference: 1.5T or 3T
Coil: Torso or Cardiac
Contrast: Gad (and Secretin if ordered)
|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|
Power Inject: Bolus trak in sagittal plane: trigger when contrast reaches SMA
|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|