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

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. Jeffrey Pollock has approved the protocols below. 

Ingenia only protocols

These protocols are to be run on all Ingenia systems: MR4, MR2, DMR2, BEAVERTON
ROUTINE BRAIN WO (replaces "Brain WO")
ROUTINE BRAIN W/WO (replaces "Brain WWO")
BRAIN TUMOR W/WO (replaces "Brain Tumor Follow Up WWO")
BRAIN + FRAMELESS WWO
FRAMELESS ONLY WITH CONTRAST
EPILEPSY/SEIZURE BRAIN WO
EPILEPSY/SEIZURE BRAIN W/WO

Brain

MRI Brain Image

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. Jeffrey Pollock has approved the protocols below.  Above 9 years old use adult protocols, except for the newly added Rapid Swift for under 16 yrs old.

Ingenia only protocols

These protocols are to be run on all Ingenia systems: MR4, MR2, DMR2, BEAVERTON
ROUTINE BRAIN WO (replaces "Brain WO")
ROUTINE BRAIN W/WO (replaces "Brain WWO")
BRAIN TUMOR W/WO (replaces "Brain Tumor Follow Up WWO")
BRAIN + FRAMELESS WWO 
FRAMELESS ONLY WITH CONTRAST
EPILEPSY/SEIZURE BRAIN WO
EPILEPSY/SEIZURE BRAIN W/WO

POWER INJECTIONS WITH SMALL IVs:

  • If the exam is with pediatric sedation, you need to let the pediatric sedation team know what size IV you need prior to them getting the patient prepped.
  • It is ok to use small IVs if that is appropriate for patient size. Hand inject during perfusion scanning instead of using the power injector, and make a note/screenshot for the rads.

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

Important notes

  • 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, and add a screen capture note to the study, and send to PACS. 

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
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.

EQUIPMENT

WORKFLOW

POST PROCESSING