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130 Cards in this Set
- Front
- Back
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General Liver Protocols |
*Localizer : Coronal breath hold incoherent GRE /SE T1 1. Axial breath hold SE T2 2. Axial SE/FSE PD/T2 3. Coronal incoherent GRE T1 |
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Kidneys protocols |
1. Coronal breath hold fast incoherent GRE/SE/FSE T1 2. Axial breath hold T2 ( fluid filled lesion ) 3. Axial T1 4. Axial T1 ( after administration of Gd-DTPA ) |
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Pancreas Protocols |
1. Coronal TSE T2 ( 6-8 mm ) 2. Axial T2 , Fat Saturation 3. Axial T1 breath hold , Fat saturation TSE.GRE ( FLASH ) - For small pancreatic tumors 4. Axial T1 fat saturation after Gd-DTPA 5. Coronal T1 fat saturation after CM |
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Slice thickness for axial pancreas |
5-6mm |
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Slice thickness for liver |
8 mm |
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Liver with super paramagnetic CM Protocols |
1. Axial T1 ( CM : Ferdiex I.V ) 2. Axial T2 ( after 1-1.5 hrs of CM ) 3. Coronal T2 after CM ( additional) |
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Liver with Gd-DTPA Protocols |
1. Axial T2 2. Axial T1 3. Axial T1 after CM 4. Axial T1 ( Dynamic ; immediate with pauses for breath in between) 5. Axial T1 ( Delayed after 5 min ) |
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Biliary MRI MRCP Protocol : |
*Paracronal ( 0-30 degree off horizontal plane ) 1. Single slice technique: T2 , fat saturation (SS-FSE) Use very long TEs ( 200ms ) and TRs ( 10 s) to nullify signal from all tissue except long T2 decay time . |
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Slice thickness for kidney ( coronal / Axial ) |
Coronal : 4-6 mm Axial : 5-6 mm |
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Small Intestine ( Hydro-MRI ) protocols: |
1.Axial T2 , fat saturation ( 8mm ) 2. Coronal T2 , fat saturation ( 6mm) 3. Axial T2 , breath hold GRE ( FLASH ) , TSE ( turbo factor 3) , (6mm) 4. Axial T1(TSE 3) breath hold 5. Coronal breath hold FSE T1 6. Coronal T1 after hyoscine butylbromide 20mg and Gd-DTPA ( 20s , 55s , 88s ) |
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General Chest protocols : |
1. Coronal breath hold fast incoherent GRE/SE T1 2. Axial SE T1 - GRE fast field echo (FFE) , breath hold and respiratory compensation 3. Axial FSE PD T2 /SS-FSE T2 |
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Additional sequences for Chest : |
1. Perfusion studies : by administration of CM or after inhalation of gas ( helium ) for evaluation of lung ventilation during inhalation . 2. Coronal fast incoherent SS-FSE T1 : during respiration to assess motion of diaphragm 3. Coronal fast incoherent GRE T1 / SS-FSE T2 |
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Heart and great vessels protocols: |
1. Coronal breath hold fast incoherent GRE/SE T1 2. Axial SE T1 3. Sagittal / Oblique SE T1 ( candy cane or walking stick ) for descending and ascending aorta 4. Oblique SE T1 or Cine coherent GER T2* multiphase , for heart function |
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Additional sequence for heart and great vessels : |
Myocardial Tagging For ventricular function By modulating the magnetization gradient , the signal from the myocardium can be nulled in grid pattern prior to the onset of image acquisition. |
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Breast protocols |
1. Axial SE/FSE/ incoherent GRE T1 ( thick slice ) 2. Sagittal SE/FSE T1 ( thin slice , small FOV ) 3. Sagittal SE/FSE T2 4. Axial/Sagittal fast incoherent GRE T1 ( pre- post CM) , thin slice through the LESION or breast 5. Sagittal 3D fast incoherent GRE T1 |
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Wrist and Hand protocols: |
As localizer : Multi-planer/ Sagittal SE/FSE / incoherent GRE T1 / coherent. 1. Coronal SE/FSE T1 2. Coronal SE/FSE T2 3. Axial FSE T2 4. Axial FSE T1 |
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Wrist and Hand protocols: |
As localizer : Multi-planer/ Sagittal SE/FSE / incoherent GRE T1 / coherent. 1. Coronal SE/FSE T1 2. Coronal SE/FSE T2 3. Axial FSE T2 4. Axial FSE T1 |
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Additional sequence for wrist for articular cartilage and carpal tunnel |
Axial PD |
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Elbow protocols |
As Localizer : Coronal / multi-planer incoherent GRE/SE/FSE T1 1. Coronal SE/FSE T1 2. Coronal FSE PD/T2 : for ID of occult fractures and joint degeneration 3. Sagittal SE/FSE T1 : for lesion 4. Sagittal STIR 5. Axial FSE T1 or PD T2 |
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Forearm protocols |
As localizer : multi-planer/ Coronal / Sagittal incoherent GRE/SE/FSE T1 1. Sagittal STIR 2. Coronal FSE/SE T1 3. Axial T1 4. Axial FSE T2 |
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Humerus and Shoulder protocols: |
AS localizer : Axial / Coronal incoherent GRE/SE/FSE T1 1. Axial SE/FSE T2 or Coherent GRE T2* 2. Coronal/Oblique SE T1 3. Coronal/Oblique FSE T2 4. Fat suppressed T2 : clear display muscle tears , trabecular injury , joint fluid and tendon tears
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Forearm protocols |
As localizer : multi-planer/ Coronal / Sagittal incoherent GRE/SE/FSE T1 1. Sagittal STIR 2. Coronal FSE/SE T1 3. Axial T1 4. Axial FSE T2 |
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Humerus and Shoulder protocols: |
AS localizer : Axial / Coronal incoherent GRE/SE/FSE T1 1. Axial SE/FSE T2 or Coherent GRE T2* 2. Coronal/Oblique SE T1 3. Coronal/Oblique FSE T2 4. Fat suppressed T2 : clear display muscle tears , trabecular injury , joint fluid and tendon tears
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Additional sequences for humerus and shoulder : |
1. Sagittal/Oblique SE T1 2. Sagittal/Oblique/Axial FSE PD T2 : for anatomical display, tendon assessment, joint cartilage and sensitivity to trabecular damage |
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Vascular Imaging protocols ( upper and lower limbs ) |
1. Coronal incoherent GRE T1 2. Axial 2D TOF-MRA |
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Knee protocols |
1. Sagittal PD T2 2. Sagittal Fat saturation 3. Coronal PD T2 4. Coronal Fat saturation |
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Knee protocols |
1. Sagittal PD T2 2. Sagittal Fat saturation 3. Coronal PD T2 4. Coronal Fat saturation |
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What is the plane used to detect lesions in the knee ( cruciate ligament, menisci , popliteal cyst ) ? |
Sagittal plane |
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Knee protocols |
1. Sagittal PD T2 2. Sagittal Fat saturation 3. Coronal PD T2 4. Coronal Fat saturation |
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What is the plane used to detect lesions in the knee ( cruciate ligament, menisci , popliteal cyst ) ? |
Sagittal plane |
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What is the protocol used for ligament imaging in knee ? |
Sagittal PD without fat saturation Fat appear bright and ligament dark gray |
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Which pathology in knee requires high resolution ( pixel size < 0.45 mm) ? |
Patella tendons injuries |
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Femur and hips protocols |
As localizer : Axial incoherent GRE SE/FSE T1 1. Coronal FSE T2 2. Sagittal FSE T2 / Coherent GRE T2 , FOR Cartilage 3. Coronal SE T1 4. Axial SE/FSE T1 5. Sagittal FSE T2 / Coherent GRE T2* |
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Common indication for knee : |
1. Assessment of internal derangement of joint tears in ligaments. 2. Evaluation of Chondromalacia patella and patella tracking . 3. Diagnosis of bone tumor or bony damage with knee joint . |
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Common indication in femur and hips : |
1. Muscles tears 2. Evaluation of unexplained unilateral or bilateral hip pain 3. Suspected occult fracture |
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Common indication in femur and hips : |
1. Muscles tears 2. Evaluation of unexplained unilateral or bilateral hip pain 3. Suspected occult fracture |
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Common indication of Chest : |
1. Assessment of diaphragmatic motion 2. Distinguish between tumor and consolidation of lung 3. Lung perfusion studies 4. Alternative of CT mediastinum and chest wall when CM is contraindications |
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Common indication of heart and great vessels : |
1. Congenital abnormalities of heart and great vessels 2. Thoracic aorta aneurism , dissection and coarctation. 3. Assessment of ventricular function 4. Valvular dysfunction 5. Vessels potency and thrombus . |
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Breast common indications |
1. Staging for benign or malignant disease . 2. Characterization of abnormalities in pt with breast implant and mammogram is not optimal. 3. Breast implant rupture 4. Characterization of abnormalities in pt with very fatty breast |
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Liver and biliary system common indications |
1. Biliary duct obstruction 2. Gallbladder disease 3. Focal lesion and staging of tumors 4. Evaluation of liver infiltrates such iron or fat 5. Benign hepatic disease ( haemoangioma ) |
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Kidneys and adrenal gland common indications |
1. Renal masses and haemorrhage 2. Adrenal masses and haemorrhage 3. Renal transplant rejection 4. Renal cell carcinoma |
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Kidneys and adrenal gland common indications |
1. Renal masses and haemorrhage 2. Adrenal masses and haemorrhage 3. Renal transplant rejection 4. Renal cell carcinoma |
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Small intestine pt preparation |
1. Pt fast at least 4 hrs 2. Drink 100ml of mannitol before 1hr 3. Pt must go to toilet 4. Explain the procedure to pt 5. Tell pt to remove clothes except underwear 6. Tell pt to remove any metallic objects 7. Place IV line |
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Pancreas common indications |
1. Pancreatic tumors 2. Pancreatic duct obstruction |
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Pancreas procedure pt preparations: |
1. Pr drink super paramagnetic CM ( negative ) 2. Go to toilet 3. Remove any metallic object and clothes except underwear 4. Explain the procedure to pt 5. Place IV line |
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Common indications of hand and wrist |
1. Assessment of wrist pain of unknown origin 2. Assessment of avascular necrosis (AVN) of scaphoid following trauma 3. Diagnosis for carpal tunnel syndrome 4. Early evaluation of rheumatoid arthritis |
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Common indications of hand and wrist |
1. Assessment of wrist pain of unknown origin 2. Assessment of avascular necrosis (AVN) of scaphoid following trauma 3. Diagnosis for carpal tunnel syndrome 4. Early evaluation of rheumatoid arthritis |
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Prone in swimmer’s position is used with which protocols? |
Elbow and forearm |
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Common indications of hand and wrist |
1. Assessment of wrist pain of unknown origin 2. Assessment of avascular necrosis (AVN) of scaphoid following trauma 3. Diagnosis for carpal tunnel syndrome 4. Early evaluation of rheumatoid arthritis |
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Prone in swimmer’s position is used with which protocols? |
Elbow and forearm |
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Elbow common indications |
1. Soft tissue mass lesions 2. Muscles tears and rupture 3. Nerve compression 4. Trauma , ulnar collateral ligament injury |
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Forearm common indication |
Visualization of bony and soft tissue abnormalities |
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Forearm common indication |
Visualization of bony and soft tissue abnormalities |
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Wrist and hand protocols patient position |
Supine with arm by side with elbow and wrist facing up to avoid pronation of forearm |
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Humerus and shoulder common indications |
1. Evaluation of shoulder pain 2. Suspected rotator cuff tear 3. Frozen shoulder syndrome 4. Evaluation of recurrent dislocation ( instability ) |
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Upper limb vascular imaging indications |
1. Arterio-venous malformation 2. Brachial artery dissection 3. Brachial artery stenosis 4. Atherosclerosis 5. Aneurysm |
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Lower limb vascular imaging indications |
1. Peripheral vascular disease ( stenosis , occlusion ) 2. Location of site of arterial bypass of occlusion 3. Evaluation of normal arterial bypass after coronary artery bypass surgery |
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What is MR arthrography technique ? |
Injecting a very dilute solution of contrast saline or very weak concentration of gadolinium into joint capsule under fluoroscopic control followed by MRI |
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What is MR arthrography technique ? |
Injecting a very dilute solution of contrast saline or very weak concentration of gadolinium into joint capsule under fluoroscopic control followed by MRI |
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Indications of MR arthrography : |
1.Diagnose rotator cuff tears 2. Glenoid labral disruption 3. Bicipital tendon 4. Chondral defect |
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What is MR Urography ( MRU ) |
It use in urinary system to visualize the renal collecting system , the ureters and bladder . * use FSE or SS-FSE with very long TEs and TRs to produce T2 images which only fluid with very long T2 decay time is seen |
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MRU Preparation in examination room |
1. Inject furosemide ( diuretic ) Up to 5 mg if obstruction is suspected 2. 30-60 sec after furosemide , Administer Gd-DTPA |
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MRU Preparation in examination room |
1. Inject furosemide ( diuretic ) Up to 5 mg if obstruction is suspected 2. 30-60 sec after furosemide , Administer Gd-DTPA |
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MRU Sequences : |
1. Paracoronal T2 , half Fourier ( RARE ) - rapid acquisition with relaxation enhancement - Single Shot TSE with breath hold 2. Paracoronal T1 , 3D spoiled Gre , 3D FLASH , Fast low angle shot , fat saturated . 3. Diffusion imaging |
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MRU Preparation in examination room |
1. Inject furosemide ( diuretic ) Up to 5 mg if obstruction is suspected 2. 30-60 sec after furosemide , Administer Gd-DTPA |
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MRU Sequences : |
1. Paracoronal T2 , half Fourier ( RARE ) - rapid acquisition with relaxation enhancement - Single Shot TSE with breath hold 2. Paracoronal T1 , 3D spoiled Gre , 3D FLASH , Fast low angle shot , fat saturated . 3. Diffusion imaging |
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MRU paracoronal T2 |
5-10 min after CM Slice thickness: 60-100mm Single slice technique: 8 sec No saturation slab |
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MRU paracoronal T1 |
Slice thickness: 2mm FOV : Large 450mm Saturation slab: Coronal , parallel to slice |
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MRU paracoronal T1 |
Slice thickness: 2mm FOV : Large 450mm Saturation slab: Coronal , parallel to slice |
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MRU diffusion imaging ( DWI or DW - MRI ) |
Use of specific MRI sequences as software that generates images form resulting data that use diffusion of water molecules to generate contrast in MR images . * SS-EPI acquisition in conjunction with parallel imaging techniques . |
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MRU paracoronal T1 |
Slice thickness: 2mm FOV : Large 450mm Saturation slab: Coronal , parallel to slice |
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MRU diffusion imaging ( DWI or DW - MRI ) |
Use of specific MRI sequences as software that generates images form resulting data that use diffusion of water molecules to generate contrast in MR images . * SS-EPI acquisition in conjunction with parallel imaging techniques . |
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When DWI is useful / Indications : |
1. Differentiate of malignant adrenal lesions from hyperplasia or adenoma 2. Differentiate renal cysts from renal cell carcinoma |
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Female pelvis common indications: |
1. Cervical lesion 2. Rectal lesion 3. Bladder lesion 4. Benign uterus tumors ( leiomyoma , fibroid ) |
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Female pelvis common indications: |
1. Cervical lesion 2. Rectal lesion 3. Bladder lesion 4. Benign uterus tumors ( leiomyoma , fibroid ) |
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Male pelvis common indications: |
1. Prostatic lesion 2. Bladder carcinoma 3. Rectal lesion 4. Infertility 5. Impotence |
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Pelvis protocols |
1. Coronal breath hold fast incoherent GRE/SE/FSE T1 2. Sagittal SE/FSE T2 ( demonstrates organ lie on the midline - bladder , uterus , cervix , rectum , prostate , penis-) 3. Axial SE/FSE T2 ( demonstrates organs lie laterally - ovaries , lymph nodes , prostate ) 4. Axial SE/FSE T1 ( +/- tissue suppression) 5. Coronal SE/FSE T2 ( tissue suppression with FSE ) |
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Pelvis protocols |
1. Coronal breath hold fast incoherent GRE/SE/FSE T1 2. Sagittal SE/FSE T2 ( demonstrates organ lie on the midline - bladder , uterus , cervix , rectum , prostate , penis-) 3. Axial SE/FSE T2 ( demonstrates organs lie laterally - ovaries , lymph nodes , prostate ) 4. Axial SE/FSE T1 ( +/- tissue suppression) 5. Coronal SE/FSE T2 ( tissue suppression with FSE ) |
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Additional sequence for pelvis: |
Fast incoherent GRE T1 ( +/- CM ) Rapid imaging after CM allows dynamic evaluation of vessels responsible for POTENCY |
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Pelvis protocols |
1. Coronal breath hold fast incoherent GRE/SE/FSE T1 2. Sagittal SE/FSE T2 ( demonstrates organ lie on the midline - bladder , uterus , cervix , rectum , prostate , penis-) 3. Axial SE/FSE T2 ( demonstrates organs lie laterally - ovaries , lymph nodes , prostate ) 4. Axial SE/FSE T1 ( +/- tissue suppression) 5. Coronal SE/FSE T2 ( tissue suppression with FSE ) |
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Additional sequence for pelvis: |
Fast incoherent GRE T1 ( +/- CM ) Rapid imaging after CM allows dynamic evaluation of vessels responsible for POTENCY |
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Which sequence necessary To characterize fat or hemorrhage within adnexa when suspected dermoid or endometriosis in female ? |
Fat saturated T1 |
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Obstetrics common indications: |
1. Evaluation of pelvic-cephalic disproportion in the 2nd or 3rd trimester of pregnancy or post delivery. 2. Evaluation of pelvic disease incidental to pregnancy and fetal abnormalities. 3. Placenta praevia |
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When the compression bands not applied in obstetrics imaging ? |
In pregnancy or immediately post Caesarean section |
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Obstetrics protocols: |
1. Sagittal SE T1 ( measure pelvic inlet and outlet by system software ) 2. Sagittal/Coronal/Axial SE/FSE , SS-FSE T1 and T2 ( STANDARD , pelvic disease - pregnancy or fetal abnormalities-) 3. Axial T1 ( after Gd-DTPA ) |
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Slice thickness and FOV of standard protocol for obstetrics is : |
3-4 mm FOV : 250-300mm |
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Brain common indications |
1. Multiple sclerosis 2. Infection 3. Hearing loss 4. Trauma |
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Brain common indications |
1. Multiple sclerosis 2. Infection 3. Hearing loss 4. Trauma |
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CM in brain |
1. Pt should fast 4-6 hrs 3. Contrast material used (Magnivest) 4. Anesthesia for children and uncooperative pt |
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High performance gradients used for : |
1. EPI 2. Diffusion 3. Perfusion |
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Brain protocols |
1. Axial/Oblique SE/FSE PD T2 ( from vertex to foramen magnum) 2. Axial T1 3. Coronal T1 4. Sagittal T2 |
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Brain protocols |
1. Axial/Oblique SE/FSE PD T2 ( from vertex to foramen magnum) 2. Axial T1 3. Coronal T1 4. Sagittal T2 |
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Additional sequences for brain provide rapid with CSF suppression by using Long TI and used For MS plaques cord lesion |
Axial/oblique FLAIR/EPI |
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Brain protocols |
1. Axial/Oblique SE/FSE PD T2 ( from vertex to foramen magnum) 2. Axial T1 3. Coronal T1 4. Sagittal T2 |
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Additional sequences for brain provide rapid with CSF suppression by using Long TI and used For MS plaques cord lesion |
Axial/oblique FLAIR/EPI |
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Additional sequence for pediatric brain |
Axial/oblique IR T1 |
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Brain protocols |
1. Axial/Oblique SE/FSE PD T2 ( from vertex to foramen magnum) 2. Axial T1 3. Coronal T1 4. Sagittal T2 |
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Additional sequences for brain provide rapid with CSF suppression by using Long TI and used For MS plaques cord lesion |
Axial/oblique FLAIR/EPI |
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Additional sequence for pediatric brain |
Axial/oblique IR T1 |
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Additional sequence for pre and post contrast to assess brain tumors |
Axial/oblique SE/FSE/incoherent GRE T1 |
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Brain protocols |
1. Axial/Oblique SE/FSE PD T2 ( from vertex to foramen magnum) 2. Axial T1 3. Coronal T1 4. Sagittal T2 |
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Additional sequences for brain provide rapid with CSF suppression by using Long TI and used For MS plaques cord lesion |
Axial/oblique FLAIR/EPI |
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Additional sequence for pediatric brain |
Axial/oblique IR T1 |
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Additional sequence for pre and post contrast to assess brain tumors |
Axial/oblique SE/FSE/incoherent GRE T1 |
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Additional sequence for rapid imaging of brain in uncooperative patients |
SS-FSE T2 |
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Brain sequence useful for high resolution imaging of small structure |
Axial 3D incoherent GRE T1 |
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Brain sequence demonstrate hemorrhage better than SE and FSE |
Axial/oblique GER/EPI T1T2 |
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Brain sequence demonstrate hemorrhage better than SE and FSE |
Axial/oblique GER/EPI T1T2 |
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Brain sequence important in investigation of Early Stroke and the effect of hypoxia and myelination pattern in pediatric |
Axial DWI |
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Contrast usage in brain |
1. Tumor assessment 2. Active MS plague 3. Infection 4. Ascertain of infract |
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Temporal lobe common indications |
1/Diagnosis and evaluation of a lesion specifically in the temporal lobes 2/Temporal lobe epilepsy 3/Diagnosis of Alzheimer’s disease and schizophrenia by Measurement of the hippocampal volume . |
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Posterior fossa and internal auditory meatus common indications |
1.Acoustic neuroma 2.Facial palsy/numbness 3.Diagnosis of a posterior fossa lesion 4. Haemifacial spasm 5.Trigeminal neuralgia(pain in the nerve) |
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Pituitary fossa common indications |
1/ Investigation of diseases related to pituitary function 2/ Hypothalamic disorders 3/ Visual field defect 4/ Post-operative assessment of pituitary adenomas |
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Orbit common indications |
1.Proptosis 2. Visual disturbance 3.Evaluation of orbital or ocular mass lesions |
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Paranasal sinuses common indications |
1/ Staging of neoplasms prior to resection 2/ Distinction of inflammation from neoplasm |
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Posterior fossa and internal auditory meatus Slice thickness |
3-4 mm |
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Posterior fossa and internal auditory meatus Slice thickness |
3-4 mm |
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Pituitary fossa slice thickness |
2mm ( possibly 1mm with overlap ) |
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Posterior fossa and internal auditory meatus Slice thickness |
3-4 mm |
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Pituitary fossa slice thickness |
2mm ( possibly 1mm with overlap ) |
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Orbit pt preparations |
1/Have an intravenous line with extension set placed 2/Ask the patient to close his/her eyes during the study? Or let the eyes opened, This enables the patient to focus and keeps the eyes still, thereby reducing motion artifact. 3/For women: no make-up which result in artifacts). 4/Ask the patient to take out any contact lenses |
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Posterior fossa and internal auditory meatus Slice thickness |
3-4 mm |
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Pituitary fossa slice thickness |
2mm ( possibly 1mm with overlap ) |
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Orbit pt preparations |
1/Have an intravenous line with extension set placed 2/Ask the patient to close his/her eyes during the study? Or let the eyes opened, This enables the patient to focus and keeps the eyes still, thereby reducing motion artifact. 3/For women: no make-up which result in artifacts). 4/Ask the patient to take out any contact lenses |
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Orbit slice thickness |
3mm |
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Posterior fossa and internal auditory meatus Slice thickness |
3-4 mm |
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Pituitary fossa slice thickness |
2mm ( possibly 1mm with overlap ) |
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Orbit pt preparations |
1/Have an intravenous line with extension set placed 2/Ask the patient to close his/her eyes during the study? Or let the eyes opened, This enables the patient to focus and keeps the eyes still, thereby reducing motion artifact. 3/For women: no make-up which result in artifacts). 4/Ask the patient to take out any contact lenses |
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Orbit slice thickness |
3mm |
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What is the chest protocol used To distinguish tumor from consolidated lung + evaluate pleural effusion or fluid pneumonia |
Axial FSE PD T2 /SS-FSE T2 |
