MRI PROTOCOLS COMPLETE-2015 - Jefferson

1 MSK MRI PROTOCOLSMSK MRI PROTOCOLSC ontentsContents Upper ExtremityUpper ExtremityPagePage ShoulderShoulder ElbowElbow WristWrist FingerFinger ThumbThumb Lower ExtremityLower Extremity Hip Hip PelvisPelvis ThighThigh KneeKnee Lower Extremity/ShinLower Extremity/Shin AnkleAnkle FootFoot Special CasesSpecial Cases Soft Tissue MassSoft Tissue Mass Metal ProtocolMetal ProtocolMSK CHESTMSK CHESTMR MSK Chest Indications:MR MSK Chest Indications: PectoralisPectoralisMajorMajor Indications:Indications: PecPecteartear Sternum / SC jointsSternum / SC joints Indications:Indications: Tumor, infection, arthritis, trauma Tumor, infection, arthritis, trauma Chest wallChest wall Indications: Indications: Trauma, tumorTrauma, tumorPectoralisPectoralisMajorMajor Use large FOVUse large FOV MedialMedial--lateral: cover to midline chestlateral: cover to midline chest SuperiorSuperior--inferior: cover down to midinferior: cover down to mid--humeral humeral.

2 702020--4040>1500>15004 x 192256 x 192223636--4848 CorCorOblOblFSTIRFSTIR161688----8080--10 0100>2000>20004 x 256256 x 256223030--3636 AxialAxialT2 FSET2 FSE161688----4040--6060>2000>20004/14/12 56 x 192256 x 192223030--3636 SagSagObliqueObliqueT2 FSET2 FSEFat SatFat : : : : : : 702020--4040>1500>15004 x 192256 x 192223030--3636 AxialAxialFSTIRFSTIR1616------minmin4004 00--8008004 x 256256 x SliceTRTETI Flip ETL : : : : : : 702020--4040>1500>15004 x 192256 x 192222020--3030 SagSagFSTIRFSTIR1616------minmin400400-- 8008004 x 256256 x 256222020--3030 SagSagT1T1161688----4040--6060>2000>2000 4/14/1256 x 192256 x 192222020--2424 CorCorobliqueobliqueT2 FSET2 : : : : : : 702020--4040>1500>15004 x 192256 x 192222424 AxialAxialFSTIRFSTIR1616------minmin4004 00--8008004 x 256256 x SliceTRTETI Flip ETL BWNex Coronal: oblique Coronal.

3 Oblique along sternum along sternum Planned from sagittal imagesPlanned from sagittal : : : : : : 702020--4040>1500>15004 x 192256 x 192222020--2424 SagSagFSTIRFSTIR1616------minmin400400-- 8008004 x 256256 x 256222020--2424 SagSagT1T1161688----4040--6060>2000>2000 4/14/1256 x 192256 x 192221414--2020 CorCorT2 FSET2 : : : : : : 702020--4040>1500>15004 x 192256 x 192221414--2020 AxialAxialFSTIRFSTIR1616------minmin4004 00--8008004 x 256256 x SliceTRTETI Flip ETL BWNex Smaller FOV for SC jointsSmaller FOV for SC joints Otherwise protocol Otherwise protocol is similar to Sternumis similar to SternumMSK MSK --Chest WallChest WallUPPER EXTREMITYUPPER EXTREMITYMR Shoulder Indications:MR Shoulder Indications: Routine ShoulderRoutine Shoulder Indications:Indications.

4 Rotator Cuff Pathology/EvaluationRotator Cuff Pathology/Evaluation MR ArthrogramMR Arthrogram Indications:Indications: Labrum Pathology/Tear Labrum Pathology/Tear Post Gadolinium Shoulder (Indirect MR Post Gadolinium Shoulder (Indirect MR Arthrogram)Arthrogram) Indications: Indications: Labral Pathology/Instability without ability to do a direct Labral Pathology/Instability without ability to do a direct arthrogramarthrogramShoulderShoulder--Ro utineRoutine1616----minimumminimum400400 --8008004 x 256256 x 256111616--1818 CorCorObliqueObliqueT1 SET1 SENonNonFatSatFatSat161688----9090--1101 10>2000>20004/14/1256 x 192256 x 192111414--1616 SagSagObliqueObliqueT2 FSET2 FSENonNonFat SatFat.

5 702020--4040>1500>15004 x 192256 x 192221616--1818 CorCorObliqueObliqueFSTIRFSTIR161688---- 2020--404020002000--300030004 x 256512 x 256221212--1414 AxialAxialPD FSEPD SliceTRTETIFlipETLBWNexMR Arthrogram ShoulderMR Arthrogram Shoulder1616minimumminimum400400--800800 3 x 192256 x 192221414 ABERABERT1 SET1 SEFat SatFat Sat1616minimumminimum400400--8008004/14/ 1256 x 192256 x 192111414 SagSagObliqueObliqueT1 SET1 SENon Non FatSatFatSat1616883030--5050>1500>15003 x 192256 x 192221414--1616 CorCorObliqueObliquePD FSEPD FSEFatSatFatSat1616minimumminimum400400- -8008003 x 192256 x 192221414--1616 CorCorObliqueObliqueT1 SE T1 SE FatSatFatSat1616minimumminimum400400--80 08003 x 192256 x 192221212--1414 AxialAxialT1 SET1 SliceTRTETIFlipETLBWNexShoulderShoulder- -Post GadoliniumPost Gadolinium(Indirect MR Arthrogram)(Indirect MR Arthrogram)**Inject standard dose of IV contrast and wait 20 minutes before**Inject standard dose of IV contrast and wait 20 minutes beforescanning**scanning**.

6 : : 702020--4040>1500>15004 x 192256 x 192221616--1818 CorCorObliqueObliqueFSTIRFSTIR883030--50 5020002000--400040004/14/1256 x 192256 x 192221414--1616 SagittalSagittalPD FSEPD FSEFatSatFatSat1616minimumminimum400400- -8008003 x 192256 x 192221414--1616 CorCorObliqueObliqueT1 SE T1 SE FatSatFatSat883030--505020002000--400040 003 x 192256 x 192221212--1414 AxialAxialPD FSEPD FSEFatSatFatSat1616minimumminimum400400- -8008003 x 192256 x 192221212--1414 AxialAxialT1 SET1 Flip ETL BWNexShoulderShoulder--Axial Imaging PlaneAxial Imaging PlaneRelevant AnatomyHumeralHeadBony GlenoidClavicleAxial Imaging PlanePrescribe plane parallel to humeral shaft.

7 Cover from top of AC joint through proximal humeral diaphysis. AC Joint(Not shown on MR)ShoulderShoulder--Coronal Imaging PlaneCoronal Imaging PlaneCoronal Imaging PlanePrescribe coronal plane off of axial images parallel to supraspinatus muscleRelevant AnatomySupraspinatusShoulderShoulder--Sa gittal Imaging PlaneSagittal Imaging PlaneHumeral HeadBony GlenoidLabrumCartilaginousLabrumAnt. and AnatomySagittal Imaging PlanePrescribe sagittal plane off axial images withline parallel to bony glenoid. Image from mid-scapulathrough deltoid MuscleMR Elbow Indications:MR Elbow Indications: Routine ElbowRoutine Elbow Indications:Indications: Biceps/Triceps tearBiceps/Triceps tear Medial/Lateral collateral ligament tearMedial/Lateral collateral ligament tear Common Flexor/Common extensor tendon pathologyCommon Flexor/Common extensor tendon pathology MR Arthrogram ElbowMR Arthrogram Elbow Indications:Indications.

8 Intra articular body evaluationIntra articular body evaluation Medial/Lateral Collateral Ligament EvaluationMedial/Lateral Collateral Ligament Evaluation Osteochondral defect (OCD)Osteochondral defect (OCD) Post Gadolinium Elbow (Indirect MR arthrogram)Post Gadolinium Elbow (Indirect MR arthrogram) Indications:Indications: IA bodyIA body OCDOCDE lbowElbow--Routine*Routine*1616882020--4 04015001500--300030003 x 256256 x 256221212--1414 SagSagPD FSEPD FSEFatSatFatSat1616882020--4040> 1500> 15003 x 256256 x 256221414--1616 CoronalCoronalPD FSEPD FSEFatSatFatSat1616minimumminimum400400- -8008003 x 256256 x.

9 702020--4040>2000>20004/14/1256 x 192256 x 192221414--1616 AxialAxialFSTIRFSTIR1616minimumminimum40 0400--8008004/14/1256 x 256 256 x 256 Flip ETL BWNex*for Biceps pathology perform FABS sequence; follow this Arthrogram ElbowMR Arthrogram Elbow1616minimumminimum400400--8008003 x 256256 x 256221212--1414 SagSagT1 SET1 SEFatSatFatSat1616883030--5050>1500>1500 3 x 256256 x 256221212--1414 CoronalCoronalPD FSE PD FSE FatSatFatSat1616minimumminimum400400--80 08003 x 256256 x 256221212--1414 CoronalCoronalT1T1 FatSatFatSat1616883030--5050>1500>15004/ 14/1256 x 256256 x 256221212--1414 AxialAxialPD FSEPD FSEFatSatFatSat1616minimumminimum400400- -8008004/14/1256 x 256256 x 256111212--1414 AxialAxialT1T1 Non

10 Non Flip ETL BWNexElbowElbow--Axial Imaging PlaneAxial Imaging PlaneRelevant AnatomyAxial Imaging Plane*Prescribe plane perpendicular to coronalplane ( ). Scan from humeral metaphysisthrough radial tuberosity. **Radial Tuberosity(bump on medial radius)Lateral and MedialHumeral Condyl