MRE Enterography W/WO BODY Protocol - Adult and Peds

Scan Notes

Last updated: 5/20/21
Charge as: Abdomen W/WO
Scanner preference: 1.5T MR1 or MR2
Coil: Torso Coil
Contrast: Gad and Glucagon

Scan Notes:

  • Patient Prep: The patient can continue to drink liquids but should not have solid food from 4 hours before the exam.
  • Patient supine
  • As of 5/13/2021: No need to check images with peds radiologist unless patient is sedated, or if there is a question or concern. 
  • Make screenshot of amount of Breeza and glucagon that was given and send to Pacs.

Breeza (oral contrast)

  • 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.
  • Sedated patients will not receive oral contrast.

Gadolinium

  • Patient will receive gad, dosed by weight.
  • Power injection, or hand inject while scanning.
  • 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. 

Scan Notes:

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.
  • Sedated patients will not receive oral contrast.

Breeza (oral contrast)

  • Patient fasting x 4-6 hours.
  • 1350 cc PO contrast ingested over 1 hour.
  • 450 cc during 0-15 min.
  • 450 cc during 15-30 min.
  • 450 cc during 30-45 min.

Gadolinium

Power Injection 2cc/sec

Glucagon

  • drawn up and administered by Rad Rn
  • CONTRAINDICATIONS: allergy, pheochromocytoma, insulinoma.
  • 0.5 mg IM pre-imaging (Adults)
  • 0.5 mg IV pre-imaging (Peds)
  • 0.5 mg IV pre-contrast (All patients)
  • Send patient home with graham crackers if possible. Encourage carbohydrates.

COVERAGE NOTES

  • Cover liver through symphysis on all sequences
  • If adult patient is tall, ok to clip the liver dome
  • Must cover symphysis pubis
  • Adjust FOV to adequately cover abdomen and pelvis A/P and L/R but do not include arms whenever possible.

MR2 INGENIA PROTOCOL

MR2 Ingenia Protocol Slice/Gap (Adults) Slice/Gap (Peds) Notes
Glucagon IM (IV for Peds) Rad Rn to inject
T2 COR SS TSE 5 skip 1 4 skip 1
T2 AX SS TSE 5 skip 1 4 skip 1
BTFE COR 6 skip 0.6 5 skip 0.6
BTFE AX UPPER 6 skip 0.6 5 skip 0.6 Do not interleave images
BTFE AX LOWER 6 skip 0.6 5 skip 0.6 Do not interleave images
BTFE COR FS 5 skip 1 4 skip 1
Glucagon IV Rad Rn to inject
mdixon T1 COR pre 3D
Contrast Power Inject @ 2 mL/sec. Trigger when contrast reaches SMA. Hand inject for small IVs (peds)
3 phase mdixon T1 COR post Same as Pre
THRIVE AX post 3D
eTHRIVE COR 3D
AX DWI 7 skip 1 5 skip 1

MR1 ACHIEVA PROTOCOL

MR1 Achieva Protocol Slice/Gap (Adults) Slice/Gap (Peds) Notes
Glucagon IM Rad Rn to inject
COR T2 SS TSE 5 skip 1 4 skip 1
COR T2 3D BTFE 3D
COR THICK BTFE 5 skip 1 4 skip 1
AX T2 SS TSE 5 skip 1 4 skip 1 OK to use two overlapping stacks for coverage. Do not interleave images.
COR T2 FS SSTSE 5 skip 1 4 skip 1
Glucagon IV Rad Rn to inject
COR T1 mDixon pre 3D
Contrast Power Inject @ 2 mL/sec. Trigger when contrast reaches SMA. Hand inject for small IVs (peds)
3 phase post COR T1 mDixon post Same as Pre
AX T1 mDixon post 3D OK to use two overlapping stacks for coverage. Do not interleave images.
AX DWI ABD 7 skip 1 5 skip 1
AX DWI PEL 7 skip 1 5 skip 1
MR Abdomen and Pelvis WWO BODY Protocol image