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17 Cards in this Set

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#1 Routine
Sagittal T1
Axial T1, T2, T2 FLAIR, DWI
#1 Routine who for?
Screening exam for young patients with H/A or vague complaints
#2 Stroke/Trauma
Sagittal T1
Axial T1, T2, T2 FLAIR, DWI, GRE
#2 Stroke/Trauma comments
Add Coronal T2 FLAIR for trauma patients


Add coronal T2 for pediatric patients
#3 Uncooperative patient ultra-fast scan
Sagittal T1

Axial T2 FLAIR, DWI, GRE
#3 Uncooperative patient ultra fast scan comments
For uncooperative patients or when there are time constraints

May be used as substitute for CT in acute emergent stroke

Acquire the above sequences in the order written
#4 Brain attack/Hyperacute stroke/MR perfusion
Sagittal T1

Axial DWI, T2 FLAIR, GRE

Axial MRA head

Axial MRA neck

Axial EPI (Perfusion, Gd+)
#4 -- for what?
Treatment decisions or complex clinical cases
#4 Requirements
18 Ga angiocath for 5cc/s injection


Functools software for studies acquired on 3T is on GE workstation

Functools for studies performed on the 1.5 T is located on the 1.5T magnet console

If MRA is ordered, should be done before the MR perfusion scan

Acquire sequences in the order written
MR perfusion additional parameters
1) EPI, single shot, MPh

2) Total # of slice selections: 9 - 12. The stack should be places where the stroke is indicated on the DWI or where it is clinically (i.e. posterior fossa if brainstem, or supratentorial above the sella).


3) Number of reteated images at each slice: 46


4) Contrast injection: Total dose is 0.2 mmol/kg; for example 40 cc for a 100 kg person. Injection rate 5cc per second, time of injection 10 sec after imaging begins, saline flush immediately follows the contrast injection with at total of 25 cc also injected at 5cc/second
#5 Mass lesion (neoplasm, infection, post-op)
Sagittal T1

Axial T1, T2, T2 FLAIR, DWI, GRE

Postcontrast Sagittal, Axial, and Coronal T1.

MRS if requested

fMRI if requested, after d/w Dr. Heier
#5 Comments
Suspected or followed intracranial mass or infection

DEFAULT CONTRAST STUDY WHEN HISTORY IS UNCLEAR
#6 Demyelinating Dz
Sagittal T1, T2 FLAIR

Axial T1, T2, T2 FLAIR, DWI

Postcontrast Sagittal and Axial T1
#6 Comments
Sagittal FLAIR to evaluate corpus callosum for demyelinating plaques

Contrast is optional, and used to help differentiate active from chronic inflammation
#7 Seizures
Sagittal T1

Axial T2 FLAIR, T2, DWI, GRE

Coronal T2 FLAIR, 3D T1 SPGR

Postcontrast Axial and coronal T1

MRS if requested

fMRI if requested
#7 Comments
Contrast is optional

Coronal FLAIR and coronal SPGR are for evaluation of the hippocampi

Coronal images should cover the entire brain

First time seizure in an adult patient requires contrast
Imaging thickness
5mm

For SPGR -- 1.5mm