Diagnostic Radiology

Diagnostic Radiology

MRI Protocols

Beaverton MRI with patient's choice of ambient lighting

This page is for OHSU's MRI technologists and physicians. It outlines all sequences and protocols currently applied in our MRI section.  Our radiologists work closely with OHSU MRI technologists in the art of creating optimal images using current technology. Protocols listed have been reviewed and approved by a radiologist.

Body imaging protocols currently applied in our MRI section.  Radiologists work closely with OHSU MRI techs in the art of creating optimal images from current technology. Dr. Alice Fung has approved the protocols below.  All body protocols for pediatric patients are under Pediatric Protocols.

Technologist tips

  • CHECKING IMAGES
    Page the Body Radiologist to check images if you have any questions regarding the exam.
     
  • PATIENT PREP
    For all Pelvic MRI studies except the Bladder Protocol or the MR Urogram: Please have the patient void their bladder prior to exam to improve image quality.

Breast Imaging  protocols currently applied in our MRI section.  Radiologists work closely with OHSU MRI techs in the art of creating optimal images from current technology. Dr. Karen Oh has approved the protocols below. 

MR Bilateral Breasts WWO Protocol
MR ISPY Breast Protocol
MR Breast Biopsy - Protocol for Technologists
MR Breast Biopsy - Post & Pillar Biopsy Method
MR Breast - Guided Wire Localization

MSK protocols currently applied in our MRI section.  Radiologists work closely with OHSU MRI techs in the art of creating optimal images from current technology. Dr. Barry Hansford has approved the protocols below.  All MSK protocols for pediatric patients are under Pediatric Protocols.

ANY INFECTION/OSTEO CASE REGARDLESS OF BODY PART:

  • If infection/osteo is a diagnostic consideration, please run 3 PLANES T1 without FS. (Infection cases aren't always ordered with contrast).
  • If for infection/osteo and is ordered with GAD, always run 3 PLANES T1 without FS PRE contrast.  (Infection cases aren't always ordered with contrast).
  • If GAD is administered, all the post contrast imaging must be fat sat, there is zero value in non fat sat post contrast imaging for MSK. 
  • DIFFICULT PATIENTS: Start exams with AX T1 non-fat sat sequences in case the exam is terminated early for difficult patients.

IF HARDWARE IS PRESENT IN THE AREA OF INTEREST:

  • Try to assess beforehand whether or not hardware will interfere with protocol. Hardware doesn't necessarily mean you have to change the protocol. If available, Check an X-ray. You may be able to decide before hand (discuss with radiologist if needed).
  • Try a fat-sat mid-TE sequence- is there too much susceptibility artifact and/or inhomogeneous fat suppression? (discuss with radiologist if needed)
  • If the protocol needs to be modified: 
    • Perform on 1.5T
    • Increase Bandwidth if possible
    • Run non-fat-sat mid-TE sequences or STIR instead of fat-sat mid-TE
    • If post-contrast, do non-fat-sat T1 instead of fat-sat T1

Upper extremities

MSK MR Adult Shoulder

Lower extremities

Chest

Neuroradiology protocols currently applied in our MRI section.  Radiologists work closely with OHSU MRI techs in the art of creating optimal images from current technology. Dr. David Pettersson  has approved the protocols below. 

Brain

MRI Brain Image

ROUTINE BRAIN WO - updated 7/14/2020
BRAIN WO TRAUMA
ROUTINE BRAIN W/WO - updated 7/14/2020
BRAIN W/WO & MRA WO - Vasculitis
BRAIN TUMOR W/WO - updated 7/14/2020
BRAIN W/WO TUMOR AND SPECTROSCOPY - updated 7/14//2020
BRAIN & ORBITS W/WO
CINE (FOR BRAIN,CSP OR LSP)
DEMENTIA - updated 6/8/2020
DTI
FRAMED STEREO WO
FRAMELESS ONLY WO, WWO OR W/CONTRAST - updated 7/14/2020
fMRI -Updated 1/7/2020
RADIATION THERAPY W/WO - updated 5/29/2020
RADIATION THERAPY AVM W/WO + MRA
MRA BRAIN WO
MRA CAROTID DISSECTION WO
MRA CAROTID DISSECTION W/WO
MRA NECK WO
MRA NECK W/WO - updated 6/29/2020
MRV (see also: Venous Thrombosis MRV WWO)
MS BRAIN WWO - updated 6/8/2020
PITUITARY W/WO + DYNAMICS
PITUITARY W/WO + RADIATION THERAPY PLANNING
PRE DBS - VIM AND THALAMOTOMY -Updated 6/3/2020
PRE DBS - GPI -Updated 8/6/2020
PRE DBS - STN -Updated 6/3/2020
EPILEPSY/SEIZURE BRAIN WO updated 6/8/2020
EPILEPSY/SEIZURE BRAIN W/WO updated 6/8/2020
SPECTROSCOPY- Single
SPECTROSCOPY- Multi
STROKE BRAIN WO
THIRD TENTRICULOSTOMY WO (EVT)
TRIGEMINAL NEURALGIA WO (BURCHIEL) -Updated 12/2/19
VENOUS THROMBOSIS / MRV W/WO
QUICK BRAIN WO

ENT

Spine

Neuroradiology protocols currently applied in our MRI section.  Radiologists work closely with OHSU MRI techs in the art of creating optimal images from current technology. Dr. David Pettersson has approved the protocols below.  Above 9 years old use adult protocols, except for the newly added Rapid Swift for under 16 yrs old.

Brain

ENT

Spine

Pediatric imaging protocols currently applied in our MRI section.  Radiologists work closely with OHSU MRI techs in the art of creating optimal images from current technology. Dr. Petra Vajtai has approved the protocols below.  The pediatric radiologists will usually protocol specific sequences they need in RIS. If not, follow the adult protocol, but make changes to the slice, gap, and FOV as needed.

MSK- upper extremities

MSK MR Adult wrist
  • For all upper extremities from finger to shoulder, use adult protocols with FOV/Slice/Gap adjustments for patient size.
  • Please run AX T1 FS PRE GAD for all MSK WWO exams.

MSK- lower extremities

For all lower extremities NOT listed below, use adult protocols with FOV/Slice/Gap adjustments for patient size.
Please run AX T1 FS PRE GAD for all MSK WWO exams.

HIPS BILATERAL POST-REDUCTION WO
HIPS PERTHES WWO 

PELVIS W/WO (Routine)
PELVIS WO (Post Anorectoplasty or Ileoanal Pull-Through)
PELVIS W/WO (Female)
PELVIS WO (Female)
PHYSEAL BAR WO
SI JOINTS WO OR W/WO

Chest

Body

MRA

Important notes -updated 12/2/19

  • Do NOT change any study parameters to reduce scan times, especially if it states in multiple places not to change parameters. 
  • Some exams are NO READ. Be sure to select the appropriate box in EPIC if the exam is not to be read by a radiologist.
  • Do NOT add a screen capture note to the study, as this will capture PHI on the images which will negate the anonymity requirement for the research study.

A4
ADNI 2 /ADNI GO
Athersys B01
Bayer Asteroid
BIOGEN IDEC
Biogen- Ascend
CSOM230C - Acromegaly
DeNovo Knee
EISAI
Focus FH/MIPO
Games- RP
Gaucher
Histogenic Knee (MR3)
INCB
INI (Insulin)
ISIS
Kinespring
Norvartis Cain 457F2302
Novartis CCNP520A2202J (5175) (Subject) 
Novartis CLCI699
Pfizer A3921119
PPMI
Roche Scarlet Road AD Study
SMM3001 Total Spine and Pelvis WO
Springworks NIR-DT-301
T2 PROTECT AD
Virtual Scopics
Vitamin D- MS Study
XOMA

Pediatric sedation

Pediatric Sedation charge nurse: 81904
Pediatric Radiology pager: 15816

OUTPATIENTS

  • Pediatric sedation outpatients check in with DCH Pediatric Sedation Services on the 7th floor of Doernbecher. 
  • Screening forms are scanned after check-in by the DCH Imaging front desk. 
  • Pediatric patients under 1 year old must have current labs if contrast is indicated.
  • MSK and Body: Pediatric Radiologist must check images before giving contrast and prior to letting the patient off the table. Neuro exams do not need to be checked unless there is a question or a concern.
    ​

INPATIENTS

  • Pediatric sedation inpatient exams are coordinated by the Pediatric Sedation Charge nurse, who will then call us for availability.. 
  • The floor nurse will fax us the screening form once it has been filled out, or will fill out the electronic form in EPIC.
  • Inpatient Pediatric patients must have current labs no older than 24 hours if contrast is indicated. Notify sedation if they need to draw blood for you to use the iStat.
  • MSK and Body: Pediatric Radiologist must check images before giving contrast and prior to letting the patient off the table. Neuro exams do not need to be checked unless there is a question or a concern.

POST PROCESSING

Perfusion on Intellispace

Post Processing Brain Perfusion on Philips Portal

Post Processing Brain Perfusion on EWS workstation

Spectroscopy Post Processing Steps

Volumetric Analysis

DTI

Separate Cine Phases

How to obtain actual numeric ADC values (rather than a map) for a ROI

pCasl Post Processing Instructions

Multivoxel post processing - Spectroview with Gausian Filter