Adult MSK MRI Protocols

INFECTION CASES:
1. If infection/osteo is a diagnostic consideration, please run 3 PLANES T1 without FS.
2. 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 PATIENT:
Start exams with AX T1 non-fat sat sequences in case the exam is terminated early for difficult patients.

HARDWARE:

1. 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).
3. 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

2. Try a fat-sat mid-TE sequence- is there too much susceptibility artifact and/or inhomogeneous fat suppression? (discuss with radiologist if needed)

All MSK protocols for pediatric patients are on the Pediatric Protocol page.