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MRI > Week 10: Abdomen > Flashcards

Week 10: Abdomen Flashcards

1
Q

All of the abdomen exams require the same patient position: supine, feet first. True or false?

A

False; MRI Abdomen requires patients to be supine, feet first, and arms up over head.

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2
Q

Exams of the abdomen require what to be perpendicular to the alignment light?

A

Mid sagittal line

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3
Q

MRI Abdomen generally uses the landmark of 2” below the xiphoid process. That changes depending on the exam’s focus. What landmark is used for liver/pancreas focus? Kidney focus?

A
  1. At the xiphoid
  2. L3 vertebrae/umbilicus
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4
Q

What landmark is used for MRI cholongiopancreatogram?

A

Xiphoid procress

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5
Q

What landmark is used for MRA renal artery?

A

2” below xiphoid process

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6
Q

What are the 3 exams of the abdomen in MRI?

A
  1. MRI Abdomen
  2. MRI Cholongiopancreatogram
  3. MRA Renal Artery
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7
Q

What coil is used for exams of the abdomen?

A

8 channel cardiac coil

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8
Q

Which of the abdomen exams use contrast (if the patient’s kidneys are good)?

A
  1. MRI Abdomen
  2. MRA Renal Artery
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9
Q

When is gating utilized during abdominal exams?

A

When the patient is unable to breath hold. Breath holding is preferred.

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10
Q

What 3 sequence options are utilized for MRI abdomen and MRCP?

A
  1. Parallel imaging
  2. Respiratory navigator box
  3. Saturation bands
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11
Q

What is the coverage area for the respirator navigator box during MRI abdomen and MRCP?

A

The box must cover half of the liver and half of the lungs

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12
Q

Saturation band placement for MRCP and MRI abdomen changes depending on the gradient used. How are they placed for axial protocols? Coronal?

A
  1. Superior to inferior
  2. Right to left
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13
Q

What are the protocols for MRI Abdomen?

A
  1. 3 plane localizer Fiesta/TrueFisp
  2. Axial T2 Fat Sat/IR
  3. Axial in- and outta-phase
  4. Coronal 3D Vibe/Lava Fat Sat
  5. Axial Flash/SPGR Fat Sat (pre- and post-contrast)
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14
Q

All protocols of the MRI Abdomen, except the 3 plane localizer, have a slice thickness of ______.

A

3mm

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15
Q

The Coronal 3D protocol of an MRI abdomen does not require isotropic volume. True or false?

A

True; isotropic only necessary for 3D exams that include MPR.

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16
Q

The post contrast axial protocol of MRI abdomen can include 4 different phases, depending on how long after contrast injection the images are collected. What are the 4 phases?

A
  1. Arterial phase
  2. Liver venous phase
  3. Late equilibrium evaluation
  4. Liver delayed enhancement
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17
Q

When is the arterial phase and what does it view?

A
  1. 20 seconds after injection
  2. Arterial vascularity of the liver
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18
Q

When is the liver venous phase and what does it view?

A
  1. 75 seconds (1 min, 15 sec) after injection
  2. Venous enhancement of the liver.
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19
Q

When is the late equilibrium evaluation and what does it view?

A
  1. 240-300 seconds (4-5 mins) after injection
  2. Outflow reactions of suspicious masses, tumors, etc.
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20
Q

When is the liver delayed enhancement phase and what does it view?

A
  1. 20 minutes after injection
  2. Any delayed vascular lesions
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21
Q

What does “Nil per os” mean?

A

NPO; no oral liquids or food

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22
Q

How long should patients be NPO prior to an MRI abdomen?

A

3 hours

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23
Q

What 3 veins compose the portal vein?

A
  1. Splenic vein
  2. Superior mesentric vein
  3. Inferior mesentric vein
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24
Q

What are the two types of tumors that can be found within the kidneys?

A
  1. Islet cell tumor
  2. Wilm’s tumor (pediatric)
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25
Q

The adrenal glands lie in the ________________ region of the abdomen.

A

Retroperitoneum

26
Q

The ________ ________ lie on the superior aspects of both kidneys.

A

Adrenal glands

27
Q

Where does the abdominal aorta lie in relation to the spine?

A

Anteriorly

28
Q

The inferior vena cava lies slightly to the ________ of the abdominal aorta?

A

Right

29
Q

What is a common artifact of abdominal studies, specifically in the kidneys?

A

Chemical shifting artifact

30
Q

Why does chemical shifting occur in the kidneys?

A

High fat and water content in close proximity

31
Q

How can chemical shifting artifacts be countered/reduced?

A

Increasing bandwidth

32
Q

What are 6 clinical concerns for MRI abdomen?

A
  1. Abdominal masses/tumors
  2. General abdominal pain
  3. Liver disorders
  4. Kidney cysts
  5. Pancreatitis
  6. Weight loss
33
Q

What are the protocols of an MRCP?

A
  1. 3 plane localizer TrueFisp/Fiesta
  2. Axial Haste/SSFSE Fat Sat
  3. Coronal Haste/SSFSE Fat Sat
  4. Radial 2D Thick T2 Haste/SSFSE
  5. Coronal 3D Space/ RTr
  6. Post-processing MiP
34
Q

What is the slice thickness in the Axial and Coronal Haste/SSFSE protocols of an MRCP?

A

4mm

35
Q

About how many radial slices are collected during the radial 2D thick T2 protocol of an MRCP?

A

~15 radial slices

36
Q

Why opt for a T2 sequence during the Radial 2D protocol of an MRCP?

A

T2 contrast allows for a brightened appearance of the gallbladder and biliary tract, while suppressing the liver and other organs.

37
Q

The coronal 3D Space/RTr collects ________ volume to use for post processing.

A

Isotropic

38
Q

Maximum intensity projection of the gallbladder and biliary tract is made possible by the collection of what?

A
  1. 2D radial data
  2. 3D isotropic volume data
39
Q

What are the three main anatomical structures viewed on an MRCP?

A
  1. Gall bladder
  2. Bile duct
  3. Pancreatic duct
40
Q

What organ produces bile?

A

Liver

41
Q

The liver is the ____-est organ in the abdomen, located in the _________ quadrant

A
  1. Largest.
  2. Upper right
42
Q

What pear-shaped organ stores concentrated bile?

A

Gallbladder

43
Q

The common bile duct is the conjoined pathway that connects what two other ducts?

A
  1. Hepatic duct from the liver
  2. Cystic duct from the gallbladder
44
Q

The pancreas produces what hormone?

A

Insulin

45
Q

The pancreas is a shortened organ with a superior slope to its placement. True or false?

A

False; the pancreas is an elongated organ with an inferior slope to its placement

46
Q

Which duct attaches to the common bile before exiting into the small intestines?

A

Pancreatic duct

47
Q

What is bile?

A

Dark green liquid that helps digest fatty foods

48
Q

Before an MRCP, patients should avoid what kind of foods to ensure that they have the maximum amount of bile present in their gallbladder?

A

Fatty foods

49
Q

Patients with kidney disease are not eligible for an MRA renal artery. True or false?

A

False; patient with kidney disorders receive a non-contrasted MRA renal artery

50
Q

What are the protocols for non-contrasted MRA renals?

A
  1. 3 place localizer Fisp/Fiesta
  2. Coronal Thin 2D Fiesta
  3. 3D TrueFisp/Enhance Inflow
  4. Axial 3D Fisp/Fiesta
  5. Sagittal-Oblique 2D CINE Phase Contrast (right and/or left)
51
Q

How thick are the slices during the Coronal thin 2D fiesta protocol of non-contrasted MRA renals?

A

3-4 mm

52
Q

The coronal thin 2-D protocol of non-contrasted MRA renals is ideal for visualizing the _________ and ____________.

A
  1. Kidneys.
  2. Renal arteries.
53
Q

The 3D TrueFisp protocol of non-contrasted MRA renals uses what type of volume slab and why?

A
  1. Isotropic.
  2. For MiP post processing
54
Q

What protocol during non-contrasted MRA renals is used for proper placement of the sagittal-oblique protocol?

A

Axial 3-D Fisp/Fiesta

55
Q

What is the approximate slice thickness in the axial 3-D protocol of non-contrasted MRA renals?

A

~1.5mm

56
Q

The axial 3D Fisp/Fiesta protocol of non-contrasted MRA renals shows the _____________ pathway on its long axis.

A

Renal artery

57
Q

The Sagittal-oblique protocol of non-contrasted MRA renals places slices perpendicular to the renal artery. True or false?

A

True

58
Q

The sagittal-oblique 2D CINE Phase Contrast protocol of non-contrasted MRA renals is only performed once, including both right and left kidneys. True or false?

A

False; the protocol must be completed twice for each individual kidney

59
Q

What are the protocols for contrasted MRA renal studies?

A
  1. 3 plane localizer Fisp/Fiesta
  2. Axial 3D Vibe/Lava Fat Sat (pre- and post-contrast)
  3. Coronal 3D Flash/SPGR (pre- and post-contrast)
60
Q

What is the slice thickness of the axial protocols of contrasted MRA renals?

A

4 mm

61
Q

What is the slice thickness of the coronal protocols of contrasted MRA renals?

A

1mm

62
Q

The coronal protocols of contrasted MRA renals plot slices parallel with the abdominal aorta. True or false?

A

False; parallel with the renal arteries

MRI (11 decks)

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