MRI PROTOCOLS 2012
Special instructions
1. Perianal fistula – Please fill up the Questionnaire
Identify the external opening of fistula tracks in the anal clock diagram . The positions should be identified with patient in supine position only .
Thin FSET2WI sections to be taken perpendicular to the long axis of anal canal lumen .
Injection of contrast through fistula tracks in selected cases only .
If abscess or supralevator extension or extension into pelvic cavity , pelvic side wall , gluteal muscles IV contrast may be given.
2. MR Perfusion
Use cannula or butterfly with 20G or 18G so that 10ml of the Gd contrast can be pushed within 2 seconds .
Ensure good flow with a pre-injection using saline .
Saline flush to be used in all cases of MR Contrast administration
3. MRI Liver
Use only Multihance as MR Contrast
Do Dual echo , GRE ,DWI ,SE sequences only after instruction to do .For routine cases these sequences are not needed
4. MRI Kidneys – The artifacts in left kidney to be taken care of . Do dual echo post contrast
5. AVN Hip - Take Digital X -ray of both hip
6. Parasellar lesions , orbital apex lesions : Post contrast FIESTA . If vessel encasement or involvement seen do post contrast angio sequence also . Take CT sections if bone erosion or sclerosis suspected .
7. Neurocysticercosis – Do FIESTA after contrast media administration .
8. Tuberculoma – Do MR perfusion , Single voxel spectroscopy .
9. MR Peripheral angiography with contrast – Do post contrast T1WI in select cases only .
10. Use Dotarem as IV contrast in cases with borderline renal failure . Gd can be given upto cretainne 4mg% . More than 2mg% carries risk . To have informed consent .Also inform clinician .
11. MRI Prostate and Uterus for endometrial carcinoma – DWI and ADC map to be done
12. MRI uterus – Do imaging in the plane of endometrium also .Axial and coronal T2 images
13.MRI Prostate – Imaging to be done in the axis of the gland.
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