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RAD4 > Final MRI Protocols > Flashcards

Final MRI Protocols Flashcards

1
Q

What is included in patient preparation for any MRI examination?

A

Surgery?
Implants? When, where?
Shrapnel?
Pre-cannulation?
Changing into a gown
Remove make-up
Secure or remove piercings and jewellery

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2
Q

What is a routine brain sequence?

A

3 plane localiser - at isocentre, 5 images, T1FS
Sagittal T1 - for midline, full head ant. and post. to temporal bones, 4-5mm slices
Axial T2 - survey pathologies and fluid structures, superior skin edge to foramen magnum, 4-mm slices
Axial FLAIR - survey pathologies especially grey and white matter, superior skin edge to foramen magnum, 4-5mm slices
Axial DWI - gold standard for strokes, superior skin edge to foramen magnum, 4-mm slices
Axial Gradient - for magnetic susceptbility (blood or calcium products), superior skin edge to foramen magnum, 4-5mm slices

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3
Q

What is the protocol for a brain ?tumour ?

A

Routine brain
Axial T1 pre contrast with hand injection of Gad
Axial T1 + C
Coronal or sagittal T1 C - orthogonal view
Optional: 3D T1 + C- for pre-operative planning or intra-operatively

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4
Q

Name an operation that would need further discussion if listen on an MRI safety questionnaire?

A

Brain surgery, ear surgery, brain aneurysm treatment, insertion of active implant

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5
Q

What are the 5 common routine brain sequences?

A

Sagittal T1, axial T2, FLAIR, DWI, GRE

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6
Q

A FLAIR sequence in the brain is very good at differentiating between —- and —-

A

Grey and white matter

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7
Q

A GRE sequence in the brain is sensitive to what blood breakdown product?

A

Haemosiderin

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8
Q

What are the common post contrast brain sequences?

A

Axial T1+C

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9
Q

What are the common post contrast brain sequences?

A

Axial T1+C and Cor T1+C

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10
Q

What is TOF MRA?

A

Time of flight MR angiography
Does not use IV Gad
Is a 3D sequence
Using MIP
Good for large blood vessels

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11
Q

What is MRV?

A

MR venography
Using IV Gad
Can be added to routine brain
Is a 3D sequence
Using MIP
Good for large blood vessel

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12
Q

What sequence should be used for the IAMs?

A

T2 thin slice
May be 2D or 3D
Done over internal and external AM
Axial and coronal views

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13
Q

When a referral says ?acoustic neuroma, what MRI sequences should be performed?

A

A routine brain scan and IAMs sequence

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14
Q

What does an IAMs sequence demonstrate?

A

Acoustic neuroma
7th and 8th cranial nerves

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15
Q

What sequences should be done for the pituitary?

A

T1 coronal and sagittal
T2 coronal and sagittal
Post contrast T1 coronal and sagittal

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16
Q

What are some limitations of a pituitary sequence?

A

A small FOV mean result in phase wrap
Therefore, use a large FOV and focus on the smaller ROI

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17
Q

What sequences should be done for a referral with ?microadenoma ?

A

T1 coronal and sagittal
T2 coronal and sagittal
T1+C coronal and sagittal
Dynamic post contrast coronal

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18
Q

What is DTI used for?

A

Diffusion tensor imaging shows the white matter tracts in the brain. It is used for mapping to aid in pre-op planning

19
Q

What is the relationship between multiple sclerosis and MRI?

A

MRI is the gold standard for imaging MS

20
Q

What is the relationship between tumour operations and MRI?

A

MRI may provide additional information or better pre-op planning for tumours

21
Q

What sequences best visualise MS?

A

T2 FLAIR

22
Q

What sequences best visualise a new stroke?

A

DWI will demonstrate the stroke with a high signal
ADC will demonstrate the stroke with a low signal

23
Q

What sequence best shows mets?

A

T2 FLAIR

24
Q

What is the appearance of metastatic melanoma?

A

T1 - hyper-intense secondary to haemorrhage or melanin
T2 - hypo-intense
T1+C - peripheral rim pattern enhancement or a diffusely heterogenous pattern

25
Q

What sequence is good for demonstrating an aneurysm?

A

TOF MRA

26
Q

A diffusion mismatch can indicate what pathology?

A

Stroke

27
Q

What is a routine spine protocol?

A

3 plane localiser - at isocentre, 5 images, T1FS
Sagittal T2
Sagittal STIR (or T2FS)
Sagittal T1
Axial T2 (all regions)
Axial T1 (depending on hx/findings)

28
Q

What is the scan range for the C spine?

A

Laterally to include just beyond vertebral bodies, sup. and inf. at least 1 vertebral body (C2-T1). And ant. to post. to ensure anatomy is at the centre of the FOV
11-15 slices with a 10-20% gap
PE direction is AP

29
Q

What is the scan range for a thoracic spine?

A

C6-L2 (include conus)
PE direction is AP
13-15 slices, 3-4mm thick with 10-20% gap

30
Q

What is the scan range for a lumbar spine?

A

T11ish (conus) to S3
PE direction is AP
13-15 slices, 4mm thick with 10-20% gap

31
Q

Occasionally, an Axial T2 lumbar spine will be done. What is the scan range for it?

A

Mid L3 to S1
PE direction is AP
19-30 slices, 4mm thick with 10-20% gap

32
Q

What is the scan range for a full spine or cord in the sagittal plane?

A

Routine C and T spine coverage
15-17 slices, 3-4 mm thick with 10-30% gap

33
Q

In a patient with scoliosis, what is the scan range for a full spine or cord?

A

4-5 sagittal sets angled across the spine at different levels
15-17 slices, 4mm thick with 10-20% gap

34
Q

What is the scan range for a full spine or cord in the axial plane?

A

20-35 slices, 4mm thick with a 10-30% gap

35
Q

What coil/s are required for spinal MRI imaging?

A

Spine array, posterior head coil, anterior neck element

36
Q

What technique modifications can be done to position a patient with kyphosis?

A

Elevating the hips to tip the head back

37
Q

What is the protocol for ?tumour in the spine?

A

Routine spine
T1 or T1FS pre contrast
Post contrast T1FS+C (sagittal and axial)

38
Q

Why would a PD sagittal sequence be added for spine trauma?

A

To assess the posterior longitudinal ligament

39
Q

Why would a GRE sagittal sequence be added for trauma/AVM

A

To survey for haemosiderin disposition for a bleed (or AVM)

40
Q

What sequence will be added for a referral with ?cord infarct ?

A

A sagittal/axial DWI

41
Q

A patient presented with significant pain, sudden leg weakness with a history of known malignant cancer. What protocol would be conducted for a ?cord compression ?

A

Full spine STIR in two FOV with axial T2

42
Q

A common indication for post contrast spine imaging is —-

A

tumour or infection

43
Q

What emergent clinical indication might require spine MRI?

A

Cord compression and epidural haematoma

44
Q

A syrinx can be well visualised on — weighted image and appear on an axial image as an area of high signal shaped in an —–

A

T2
Oval/circle

RAD4 (3 decks)

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