Cornell Mr Protocols

Front 1

#1 Routine

Back 1

Sagittal T1
Axial T1, T2, T2 FLAIR, DWI

Front 2

#1 Routine who for?

Back 2

Screening exam for young patients with H/A or vague complaints

Front 3

#2 Stroke/Trauma

Back 3

Sagittal T1
Axial T1, T2, T2 FLAIR, DWI, GRE

Front 4

#2 Stroke/Trauma comments

Back 4

Add Coronal T2 FLAIR for trauma patients


Add coronal T2 for pediatric patients

Front 5

#3 Uncooperative patient ultra-fast scan

Back 5

Sagittal T1

Axial T2 FLAIR, DWI, GRE

Front 6

#3 Uncooperative patient ultra fast scan comments

Back 6

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

Front 7

#4 Brain attack/Hyperacute stroke/MR perfusion

Back 7

Sagittal T1

Axial DWI, T2 FLAIR, GRE

Axial MRA head

Axial MRA neck

Axial EPI (Perfusion, Gd+)

Front 8

#4 -- for what?

Back 8

Treatment decisions or complex clinical cases

Front 9

#4 Requirements

Back 9

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

Front 10

MR perfusion additional parameters

Back 10

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

Front 11

#5 Mass lesion (neoplasm, infection, post-op)

Back 11

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

Front 12

#5 Comments

Back 12

Suspected or followed intracranial mass or infection

DEFAULT CONTRAST STUDY WHEN HISTORY IS UNCLEAR

Front 13

#6 Demyelinating Dz

Back 13

Sagittal T1, T2 FLAIR

Axial T1, T2, T2 FLAIR, DWI

Postcontrast Sagittal and Axial T1

Front 14

#6 Comments

Back 14

Sagittal FLAIR to evaluate corpus callosum for demyelinating plaques

Contrast is optional, and used to help differentiate active from chronic inflammation

Front 15

#7 Seizures

Back 15

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

Front 16

#7 Comments

Back 16

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

Front 17

Imaging thickness

Back 17

5mm

For SPGR -- 1.5mm