GE MRI磁共振操作手册编订

扫描窗口
内容
➢ 系统导航 ➢ 系统扫描设定窗口 ➢ 扫描窗口
1. 初始窗口简介 2. 患者信息登录窗口 3. 扫描协议选择窗口 4. 患者位置窗口 5. 定位管理窗口 6. 三平面定位窗口 7. 定位信息总结窗口 8. 扫描按键介绍
系统导航
当前所处的时间当前状态下系统能存储的图像数量当前的磁盘空间使用情况系统信息提示窗口扫描窗口信息编辑窗口图像处理窗口网络传输窗口维修服务窗口远程服务窗口图像重建状态照相状态保存MOD图像状态网络传输状态
其中SCND，ACT，RXD的序列点击Download下载后可以扫描，其他序列都是还没有保存的序列，不能下载
其他扫描窗口介绍－定位管理窗口
Copy Series：复制被点中扫描序列 Paste Series：粘贴扫描序列到被点中序列后面 Paste GRx：粘贴定位信息 Copy Notes：复序列注释 Paste notes：粘贴序列注释 Cut Series：剪切扫描序列
Copy Scan Coverage：复制扫描范围 Copy FOV, Thickness, Spacing：复制扫
描视野、层厚、层间隔 Copy SAT：复制饱和带 Copy Shim Volume：复制局部匀场 More Filter 2D：二维和三维定位线的相互复制。主要是指复制覆盖范围和倾斜角度
MRI扫描总论
MR设备分布图
MRI基本操作介绍
1. 系统开机 2. 系统关机 3. TPS Reset
开机
，
开机初始界面
关机
TPS Reset
操作界面介绍
内容
➢ 系统导航 ➢ 系统扫描设定窗口 ➢ 扫描窗口
1. 初始窗口简介 2. 患者信息登录窗口 3. 扫描协议选择窗口 4. 患者位置窗口 5. 定位管理窗口 6. 三平面定位窗口 7. 定位信息总结窗口 8. 扫描按键介绍
扫描窗口
内容
➢ 系统导航 ➢ 系统扫描设定窗口 ➢ 扫描窗口
1. 初始窗口简介 2. 患者信息登录窗口 3. 扫描协议选择窗口 4. 患者位置窗口 5. 定位管理窗口 6. 三平面定位窗口 7. 定位信息总结窗口 8. 扫描按键介绍
其他扫描窗口介绍－三平面定位窗口
冠状位定位图像的装载位置矢状定位图像的装载位置
定位信息总结
Rx Scan Time: 该序列总的扫描时间＃ of Acqs:总的采集次数。常规保证为1，如果不是1可以通过增加TR时间来实现 Max # of Slices：一次采集的最到扫描层数。 Totol ＃ of Slices：该序列总的扫描层数 Rel. SNR：相对SNR。从扫描协议中下载序列后，初始状态下为100％，随后会根据参数的实时调整其大小。 Est SAR & Peak SAR：估计 SAR值和峰值SAR值。在1.5T MR 上基本可以忽略这个选项。但是在3.0T上，Est SAR非常重要，最好低于2.4，这样就能够保证扫描的流畅进行 dB/dt & SAR：扫描选择的模式是normal 还是first Level
注意黄色激活框位于矢状位轴位定位图像的装载位置浏览图像的滚动条划定位线窗口加饱和带窗口脂肪抑制功能键定位工具栏局部匀场调整放射状定位工具保存定位线扫描协议笔记：可以记录扫描注意事项定位信息总结
初始界面
三平面定位窗口—工具栏
Erase Selected：删除选中内容
Erase All：删除全部的定位线、饱和带常规不推荐使用
患者登记
扫描窗口
内容
➢ 系统导航 ➢ 系统扫描设定窗口 ➢ 扫描窗口
1. 初始窗口简介 2. 患者信息登录窗口 3. 扫描协议选择窗口 4. 患者位置窗口 5. 定位管理窗口 6. 三平面定位窗口 7. 定位信息总结窗口 8. 扫描按键介绍
其他扫描窗口介绍－扫描协议选择窗口
其他扫描窗口介绍－扫描协议选择窗口
Scan modes窗口
Scan modes窗口
Scan modes窗口
Scan modes窗口
Scan modes窗口
Scan modes窗口
Scan modes窗口
自动语音管理窗口
内容 ➢ 窗口介绍 ➢ 增加自定义语言命令 ➢ 自定义语音录制 ➢ 默认语音设定
自动语音管理窗口—窗口介绍
1. 初始窗口简介 2. 患者信息登录窗口 3. 扫描协议选择窗口 4. 患者位置窗口 5. 定位管理窗口 6. 三平面定位窗口 7. 定位信息总结窗口 8. 扫描按键介绍
扫描窗口－初始窗口简介
患
者
登
记
自
窗
动
口
浏
览
窗
口
扫
描
定
位
窗
口
扫描窗口
内容
➢ 系统导航 ➢ 系统扫描设定窗口 ➢ 扫描窗口
1. 初始窗口简介 2. 患者信息登录窗口 3. 扫描协议选择窗口 4. 患者位置窗口 5. 定位管理窗口 6. 三平面定位窗口 7. 定位信息总结窗口 8. 扫描按键介绍
Prep Scan＝自动预扫描＋序列准备
Auto Prescan即自动预扫描，系统遵循如下步骤完成预扫描找中心频率调节射频增益调节R1和R2的值根据扫描区域实时调节匀场
Smart Prescan即优化预扫描，它是常规扫描的默认预扫描方式。遵循如下步骤完成预扫描
找中心频率调节射频增益调节R1和R2的值根据扫描区域实时调节匀场当前一个扫描序列的中心位置与本次扫描的位置差别在12cm内，系统会自动利用前一次扫描的中心频率、匀场，以缩短预扫描时间当两个序列完全相同，系统会完全利用前一次扫描的预扫描结果进行此次扫描
1. 初始窗口简介 2. 患者信息登录窗口 3. 扫描协议选择窗口 4. 患者位置窗口 5. 定位管理窗口 6. 三平面定位窗口 7. 定位信息总结窗口 8. 扫描按键介绍
其他扫描窗口介绍－定位管理窗口
其他扫描窗口介绍－定位管理窗口
SCND：已经扫描完毕并且出图的图像 ACT：正在扫描的序列或已经下载准备扫描的序列 RXD：编辑完毕，已经保存的序列 REV：已经复制定位线，但是还没有保存的序列 INRX：正处于编辑状态的序列 NEW：新的扫描序列
扫描窗口
内容
➢ 系统导航 ➢ 系统扫描设定窗口 ➢ 扫描窗口
1. 初始窗口简介 2. 患者信息登录窗口 3. 扫描协议选择窗口 4. 患者位置窗口 5. 定位管理窗口 6. 三平面定位窗口 7. 定位信息总结窗口 8. 扫描按键介绍
系统扫描设定窗口
Scan modes窗口
Scan modes窗口
饱和带上红色室线移动位置圆点调节角度正方点调节厚度
饱和带越薄，抑制效果越好
扫描窗口
内容
➢ 系统导航 ➢ 系统扫描设定窗口 ➢ 扫描窗口
1. 初始窗口简介 2. 患者信息登录窗口 3. 扫描协议选择窗口 4. 患者位置窗口 5. 定位管理窗口 6. 三平面定位窗口 7. 定位信息总结窗口 8. 扫描按键介绍
Keep W/L：保持窗口窗位不变。指定位框内图像在翻页时保持被调整的窗宽窗位不变推荐常规使用 Report Cursor：实时报告光标的三维空间位置
Update All：全部更新。指在定位框内图像移动位置、放大、调节窗宽床位时三个定位框同时调整 Reset Center：利用激活定位图的中心点重新设置定位线的中心点 Display Normal：恢复到默认的窗宽窗位、放大倍数、移动位置 Loc Ref Lines：实时显示三个显示窗口之间的定位关系
其中前缀为SCND，ACT，INRX的序列不能被剪切
其他扫描窗口介绍－定位管理窗口
New Series：增加新的扫描序列 End Exam：结束本次扫描 View Edit：编辑扫描序列，即是划定位线 Download：扫描序列下载 Save Rx as Protocol：将已经扫描的序列保存为一个新的扫描协议 AutoScan：自动扫描已经保存好的序列 AutoStep：只在SmartStep扫描序列中中应用
Reset Value：重置扫描参数到初始状态，
扫描窗口
内容
➢ 系统导航 ➢ 统扫描设定窗口 ➢ 扫描窗口
1. 初始窗口简介 2. 患者信息登录窗口 3. 扫描协议选择窗口 4. 患者位置窗口 5. 定位管理窗口 6. 三平面定位窗口 7. 定位信息总结窗口 8. 扫描按键介绍
扫描按键介绍
Scan =优化预扫描＋序列准备＋正式扫描
—＋：图像翻页
Accel Bar：快速查找图像，输入图像编号即可
Fallback to R0：定位线左右方向中心点归零。由于有3平面定位的原因，极少不用
ZOOM：图像放大/缩小
复制定位线选项
三平面定位窗口—Copy Rx
复制定位线实际上就是复制定位线在三个方向（上下SI，左右RL，前后 AP）上的起点和终点。 Original Loc的复制就是将SI/RL/AP三个方向的信息完全复制 Present Loc复制的含义就是在被激活的定位图像上复制定位信息。以轴位图像为例，它在层面内有RL和AP两个坐标轴，在SI方向上是一个点。如果以它为定位图像利用Present Loc复制定位线，就是在一个固定的SI点上复制定位线，即只是复制了AP和RL，
三平面定位窗口—Select Series
三平面定位窗口—增加饱和带
点击SAT进入饱和带编辑窗口
根据需要点击相应的饱和带，共有上S、下I、前A、后P、右 R、左L六个饱和带的默认位置是所划的定位线的边缘30mm外。厚度是 40mm
如果点击一个饱和带，然后在图像上点击一次左键，饱和带就出现在图像内。
扫描窗口
内容
➢ 系统导航 ➢ 系统扫描设定窗口 ➢ 扫描窗口

合集下载

GE_1.5T磁共振操作指南定位线示例神经系统

不同地区的医院可根据自己的特色选择上面的脉冲序列
2/ GE /
头颅矢状位
首先选取横轴位图像
2
1
在横轴位图像上划矢状位定位线，调准角度，与脑组织中线平行
在冠状面上调整角度,与大脑镰平行
在矢状面上调整角度,使头显示正位
矢状位扫描常规采用T1WI
主要的目的是观察中线结构有无发育异常、先天畸形。同时还可以从多个角度观察脑组织的结构
不同地区的医院可根据自己的特色选择上面的脉冲序列
10 / GE /
海马扫描
2 划定位线与海
马长轴垂直
1
1
海海马马常常规规扫扫描描序序列列包包括括
AAXXIIAALLTT22FFRRFFSSEE33mmmm AAXXIIAALLTT11FFLLAAIIRR33mmmm 00CCOORRTT22FFLLAAIIRR22mmmm CCOORRMMRRSSSSVV
2 定位以冠状面
不同地区的医院可根据自己
和矢状面图像双重定位,矢状面上定位
的特色选择上面的脉冲序列
平行于前颅底,冠状
尽量左右对称
9/
GE /
海马扫描
1 冠状面扫描比
较特殊,应该垂直海
1
马长轴.
首先调整三平面定位的矢状面图像找
1
到海马,见箭头
海马常规扫描序列包括
AXIAL T2 FRFSE 3mm AXIAL T1 FLAIR 3mm 0COR T2 FLAIR 2mm COR MRS SV
不同地区的医院可根据自己的特色选择上面的脉冲序列
1 1
15 / GE /
不不同同地地区区的的医医院院可可根根据据自自己己的的特特色色选选择择上上面面的的脉脉冲冲序序列列

核磁共振仪器操作说明书

核磁共振仪器操作说明书一、引言核磁共振仪器是一种高精度的科学仪器，广泛应用于医学、化学、材料科学等领域。

本操作说明书旨在提供详细的操作步骤和注意事项，帮助用户正确操作核磁共振仪器，保证实验的准确性和安全性。

二、器材准备1. 核磁共振仪器主机2. 氦气罐3. 液氮容器4. 样品管5. 数据处理软件三、仪器操作步骤1. 准备工作在开始操作核磁共振仪器之前，确保所有所需器材齐全并处于正常工作状态。

检查氦气罐和液氮容器的气压和液位是否符合要求。

2. 启动仪器按照仪器启动流程，确保主机通电，系统能够正常运行。

在启动过程中，注意检查各个仪器部件是否显示正常，如液晶屏和指示灯等。

3. 样品制备根据实验需求，选择合适的样品进行制备。

确保样品纯净，并根据操作要求将样品注入样品管中。

4. 样品加载小心地将装有样品的样品管放置到样品腔中，并关闭腔门。

注意确保样品管正确安装，避免产生任何泄漏。

5. 调谐过程通过调节仪器参数，使得核磁共振信号得以最大化。

根据仪器操作面板上的指导，进行调谐过程并进行优化，以获得更准确的信号。

6. 参数设置根据实验要求，选择合适的参数设置。

可调节谱宽、重复时间、扫描次数等参数，以获得所需的仪器输出。

7. 开始扫描确认参数设置无误后，点击仪器操作面板上的“开始”按钮，启动扫描过程。

在扫描过程中，谨慎处理样品管，避免对结果产生影响。

8. 数据处理扫描结束后，将得到的数据导入数据处理软件中进行处理。

可根据实验需求选择合适的数据处理方法，如傅里叶变换等。

四、注意事项1. 操作前必须佩戴好个人防护装备，包括实验手套和护目镜等。

2. 严禁个人未经许可进行仪器调试和维护。

3. 液氮和氦气具有低温特性，请谨慎操作，避免受到伤害。

4. 使用时，保持操作环境干净整洁，避免对仪器和样品产生污染。

5. 操作结束后，及时关闭仪器电源并做好相关的清洁工作。

6. 遵守实验室规章制度，确保个人和他人的安全。

五、故障排除在操作核磁共振仪器过程中，遇到故障时，请参考以下排除方法：1. 仪器无法启动：检查电源是否连接正常，确保主机通电。

GE_1.5T磁共振操作的指南_定位线示例(神经系统)

不不同同地地区区的的医医院院可可根根据据自自己己的的特特色色选选择择上上面面的的脉脉冲冲序序列列
12 / GE /
海马扫描
3 在冠状位定位
图像上将定位框移动到中心位置
1 1
海马常规扫描序列包括
AXIAL T2 FRFSE 3mm AXIAL T1 FLAIR 3mm 0COR T2 FLAIR 2mm COR MRS SV
方向,使之为正冠状
8/
位
GE /
内听道扫描
1 3D 扫描的层块
覆盖范围一定要大
于内听道的上下限, 也就是说扫出来得
1
1
图像前8张和后8张
都不应该有内听道内听道常规扫描序列包括
显示,以保证图像质
量
AXIAL T2 FRFSE 2mm
COR T2 FRFSE 脂肪抑制 2mm
3D FIESTA 1mm
不同地区的医院可根据自己的特色选择上面的脉冲序列
13 / GE /
副鼻窦扫描
1 轴位扫描在矢
状位上自前颅底向下包括鼻咽部至口咽部
副鼻窦常规扫描序列包括
AXIAL T2 FRFSE 4mm AXIAL T1 FLAIR 4mm AXIAL T2 FLAIR 4mm AXIAL T2 FRFSE 脂肪抑制 SAG T2 FRFSE 脂肪抑制
1
1
在三平面的轴位图像上调整显示框的角度,使之为正轴位显示
内听道常规扫描序列包括
AXIAL T2 FRFSE 2mm COR T2 FRFSE 脂肪抑制 2mm
3D FIESTA 1mm
2 冠状位在轴位
图像上定位, 尽量左右对称,并在冠状
不同地区的医院可根据自己的特色选择上面的脉冲序列

GE 1.5T磁共振操作指南-腹部扫描简介ppt课件

腹部扫描方法
GE Signa Twinspeed 1.5T
GE 1.5T磁共振操作指南-腹部扫描简介
1
1 打开门控管理器
GE 1.5T磁共振操作指南-腹部扫描简介
2
门控管理器
打开呼吸门控
GE 1.5T磁共振操作指南-腹部扫描简介
3
2 打开呼吸触发窗口 1 编辑呼吸触发的序列
GE 1.5T磁共振操作指南-腹部扫描简介
7பைடு நூலகம்
或减少回波数，可以增加每
次采集的扫描层数。（逐步减小回波数，使每次采集层数达到定位层数的要求。）
GE 1.5T磁共振操作指南-腹部扫描简介
8
对于屏气扫描序列，如果扫描层数大于最大采集层数，扫描时间翻倍，此时“#次扫描前暂停”键点亮。为防止病人屏不住气，将值由0改为1。
GE 1.5T磁共振操作指南-腹部扫描简介
9
4
呼吸间隔，一般当呼吸频率在15次/ 分以下用1； 15-30次/分用 2；30次/分以上用3
更新呼吸频率
GE 1.5T磁共振操作指南-腹部扫描简介
5
画定位线，注意层数不能超过单次采集最大扫描层数
GE 1.5T磁共振操作指南-腹部扫描简介
6
如果层数过多，减少扫描层数
GE 1.5T磁共振操作指南-腹部扫描简介

GE磁共振操作规程

G E磁共振操作规程(总1页) -CAL-FENGHAI.-(YICAI)-Company One1
-CAL-本页仅作为文档封面，使用请直接删除
磁共振操作规程
1、每天开机前先检查电源工作是否正常，再记录液氦量和磁体压
力，观察氦压机是否正常工作，检查水冷机温度是否正常。

2、确认以上各环节正常时方可开机。

依次打开主机电源、激光相
机电源。

3、接诊时，核对患者一般资料，询问病史，明确检查目的和要
求，制订合理的检查程序和扫描序列。

4、进入检查室前，应要求患者除去身上一切金属物品、磁性物品
及电子器件，向患者认真讲述检查过程，以消除其恐惧心理，争取患者的合作。

5、检查时严格按照各部位的成像方法，力求正确、高质量完成每
例检查，获得最佳的成像每张申请单及其照片，确保无一疏漏。

6、关机时严格按照关机程序，待电脑提示整理稳完毕，可以关机
时再关闭主机电源和激光照相电源。

7、完成每天的检查后，仔细核对。

GE T磁共振操作指南定位线示例神经系统

1
1
垂体常规扫描序列包括
AXIAL T2 FRFSE
2 冠状位在矢状
位图像上定位,调整角度,尽量与垂体柄平行
SAG T1 SE COR T1 SE 动态T1 FSE SAG T1+C
COR T1+C
不同地区的医院可根据自己
的特色选择上面的脉冲序列
7/
GE /
内听道扫描
1 轴位扫描与矢
状位前颅底平行,自颅底向下扫描15层左右.
不同地区的医院可根据自己的特色选择上面的脉冲序列
13 / GE /
副鼻窦扫描
1 轴位扫描在矢
状位上自前颅底向下包括鼻咽部至口咽部
副鼻窦常规扫描序列包括
AXIAL T2 FRFSE 4mm AXIAL T1 FLAIR 4mm AXIAL T2 FLAIR 4mm AXIAL T2 FRFSE 脂肪抑制 SAG T2 FRFSE 脂肪抑制
1
1
垂体常规扫描序列包括
AXIAL T2 FRFSE
2 冠状位在矢状
位图像上定位,调整角度,尽量与垂体柄平行
SAG T1 SE COR T1 SE 动态T1 FSE SAG T1+C
COR T1+C
不同地区的医院可根据自己
的特色选择上面的脉冲序列
6/
GE /
垂体扫描
1 矢状位中画定
位线，调准角度，在冠状面和轴位图像上与正中线平行
定位线示例（部分）
GE Signa Twinspeed 1.5T
1/ GE /
头颅轴位
1 矢状位中画定
2
1
位线，调准角度，与胼胝体前后联合连线平行，线中点位于脑干前缘。

GE_1.5T磁共振操作指南——图像浏览及后处理简介

远程主机名远程主机IP地址
端口号
1 选中远程主机，点“update”进行设置
更新；或点“add”添加新的远程主机。
2 远程主机设置窗口。
10 / GE Title or job number /
6/5/2007
1 点击队列，在下拉菜单
中选择存档/传输/打印任务
2 打开队列管理窗口，显
示执行存档/传输/打印任务的序列的状态。
像调至左右观位
3 根据需要剪除外
部或内部组织结构
18 / GE Title or job number /
6/5/2007
2 拖拉
鼠标左键勾勒出血管边界
1 点A或P键将3D图
像调至前后观位
3 根据需要剪除外
部或内部组织结构
19 / GE Title or job number /
6/5/2007
7/ GE Title or job number /
6/5/2007
排序－－如：将检查按患者姓名字母顺序排序
8/ GE Title or job number /
6/5/2007
网络传输－－先选中远程主机，点“OK”确认。
9/ GE Title or job number /
6/5/2007
6/5/2007
选择－－用下拉菜单选择“Select all Series”，选中某一检查的所有序列；同样，也可以选中某一序列中的所有图像
6/ GE Title or job number /
6/5/2007
删除－－选中检查/序列/图像，点“Remove exams/Series/images”可删除。
1 将MIP改
为HD MIP，高分辨率最大强度投影

GE15T磁共振操作指南-定位线示例骨关节

2 矢状位中调整
定位线前后位置及角度，尽量多包住腘窝，同时与膝关节关节面垂直。
2
1
3/ GE /
膝关节矢状面（3D）
1选择显示股骨髁
2
状突最好的横断面，平行于外侧髁画定位线。保证一条定位线通过内侧髁外侧面。
2冠状位上调整角
1
度，使定位线垂直
于关节面。
4/ GE /
下肢（小腿）
冠状面/矢状位上定横断位，垂直胫骨骨干，包全病变。
2 矢状位中调整
定位线上下位置及角度，与桡骨骨干平行。
3 横断位中调整
定位平面，与桡骨长轴平行。
2
1
7/ GE /
1
备注：根据病灶大小
范围调整层厚及层间
距；多发病变可用
Shift+鼠标左键多段定位法
2
5/ GE /
ቤተ መጻሕፍቲ ባይዱ
下肢（小腿）
1横断位上定冠状/
矢状位，包全病变
2矢状/冠状位上定
冠调整定位线与胫骨骨干/病变长轴平行。
2
1
6/ GE /
腕关节冠状位
1横轴位调整到显
示桡尺骨茎突最好的层面，平行两者连线画定位线。
Knee 矢状位扫描
1 选择显示股骨髁
状突最好的横断面，平行于外侧髁画定位线。保证一条定位线通过内侧髁外侧面。
2冠状位上调整角
度，使定位线垂直于关节面。
膝关节矢状位扫描以倾斜定位为
膝关节压脂序列常规需要加shim volume，shim的大小应小于FOV，放置在生理曲度比较大的位置。
1/ GE /
膝关节矢状面
1 横轴位调整到
显示内外侧髁最好的层面，画定位线，调准角度，与股骨外侧髁斜边平行，保证其中一条定位线通过内侧髁外侧面。

GE型号MR产品使用指南说明书

INTRODUCTIONThese magnetic resonance (MR) protocols were developed by an expert consensus panel for use on General Electric (GE) MR imaging machines, and were developed for high-end platform scanners with multichannel phased array coils and parallel reconstruction capabilities. The protocols are divided into 3 sections:•Body MR imaging•Body MR angiography•Central nervous system (CNS) MR imagingThe protocol parameters can generally be adapted to work with other software platforms or releases and hardware configurations but may require small modifications that can be made by a knowledgeable and experienced MR technologist. Scan times may increase in some circumstances.These protocols provide field strength–specific parameters for 1.5T and 3T. Attention has also been given to patient preparation, streamlining the exam, and making the best use of contrast material, whether it is a standard gadolinium-based extracellular fluid agent, a high-relaxivity gadolinium-based contrast agent (GBCA), such as MultiHance® (gadobenate dimeglumine [Gd-BOPTA]), or agents with hepatobiliary uptake such as Eovist®(gadoxetic acid) and MultiHance®.Each protocol contains a brief description of patient preparation, special notes on coil choice and placement, suggestions for contrast dose and administration rate, and suggestions concerning timing of fluoroscopic triggering, if appropriate.The consensus panel consisted of the following experts in radiology:Thomas Grist, MD University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Mark C. DeLano, MD ̶ Michigan State University, Advanced Radiology Services, PC, Grand Rapids, Michigan Scott B. Reeder, MD, PhD ̶ University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Howard A. Rowley, MD ̶ University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Steffen Sammet, MD, PhD, DABR, DABMRS, FAMP ̶ The University of Chicago Medical Center, Chicago, Illinois Megan E. Vadnais, BSRT, (R)(MR) ̶ University of Wisconsin School of Medicine and Public Health, Madison, WisconsinDisclaimerThe content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Medical Education Resources, ABC Medical Education, and/or Bracco Diagnostics Inc. The authors have disclosed if there is any discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration (FDA) in their presentations. The protocols presented here were developed for pediatric and adult patients of average weight.Before prescribing any medicine, primary references and the full prescribing information for each product should be consulted. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. The information presented in this activity is not meant to serve as a guideline for patient management.Off-Label StatementThis educational activity contains discussion of published and/or investigational uses of agents that are not on-label by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, participants should critically appraise the information presented and are encouraged to consult appropriate resources for any product or device mentioned in this activity.MR Protocols for Body MR ImagingContrast timing is extremely important for abdominal MR imaging, particularly for high-quality liver imaging. We recommend the use of fluoro-triggering or “SmartPrep” methods rather than the use of a timing bolus.All body MR imaging protocols presented here were developed by Scott B. Reeder, MD, PhD, Steffen Sammet, MD, PhD, DABR, DABMRS, FAMP, and Megan E. Vadnais, BSRT, (R)(MR) for 1.5T and 3T systems. Specific protocols include:•Abdomen‒ Generic Abdomen Pelvis 1.5T and 3T‒ Appendicitis Noncontrast 1.5T and 3T‒ MR Enterography 1.5T and 3T•Liver‒ Liver/Pancreas Extracellular Agent 1.5T and 3T‒ Liver/Pancreas Hepatobiliary Agent 1.5T and 3T‒ Magnetic Resonance Cholangiopancreatography (MRCP) Noncontrast 1.5T and 3T‒ Diffuse Liver Disease 1.5T and 3T•Pelvis‒ Generic Pelvis 1.5T and 3T‒ Female Pelvis Malignant 1.5T and 3T‒ Female Pelvis Benign 1.5T and 3T‒ Uterine Anomaly 1.5T and 3T‒ Rectal Cancer 1.5T and 3T‒ Perianal Fistula 1.5T and 3T‒ Prostate 1.5T and 3T•Adrenal and Renal‒ Adrenal 1.5T and 3T‒ Renal 1.5T and 3TGeneral Notes•Intravenous access should be obtained with an 18- to 22-gauge needle•We suggest the use of a contrast injector and a saline flush of a minimum of 20 to 30 mL at the same injection rate as the contrast injection (1.5-2.0 mL/sec)•Breath-holding is essential for good image quality for thoracic or abdominal MR imaging. Precontrast scans should be used to ensure that the patient can both breath-hold adequately and understand the instructions. We recommend breath-holding at end-expiration (end tidal volume)•When parallel imaging is used, care must be taken to increase the field of view sufficiently to avoid residual aliasing artifact. This is generally more often a problem for coronal imaging, which may require placing the arms over the head or elevating the arms by the patient’s side•In patients with renal failure, consider using a half-dose (0.05 mmol/kg) of a high-relaxivity Group II contrast agent such as MultiHance® (gadobenate dimeglumine), particularly at 3TMR Protocols for Body MR AngiographyAll protocols should use Fluoro-Triggered (FT) magnetic resonance (MR) angiography fluoroscopic imaging for bolus detection. MR imaging protocols for MR angiography presented here include 1.5T and 3T systems, and were developed by Thomas Grist, MD, and Megan E. Vadnais, BSRT, (R)(MR) for the following procedures:•Cardiac MRA–Cardiac Basic Anatomy and Function 1.5T and 3T–Pulmonary Artery 1.5T and 3T–Pulmonary Vein Mapping 1.5T and 3T•Thoracic MRA–Thoracic Aorta MRA 1.5T and 3T–Gated Thoracic Aorta 1.5T and 3T•Abdominal MRA–Contrast-enhanced MRA Abdomen 1.5T and 3T–Noncontrast-enhanced MRA Abdomen 1.5T and 3T–Thoracoabdominal Aortic Aneurysm MRA 1.5T and 3T•Peripheral MRA–Lower Extremity Contrast-enhanced MR Venography (CE MRV) 1.5T and 3T–Runoff Abdomen to Lower Extremity MRA 1.5T and 3T–Peripheral Runoff Noncontrast 1.5T and 3T–Arteriovenous Malformation (AVM) Evaluation 1.5T and 3TThe rationale for the patient preparation for contrast-enhanced MR angiography is based on a hypothetical generic patient. Individual protocols may include important variations and will be delineated in the specific protocol. General Notes•Intravenous access should be obtained with an 18- to 22-gauge needle, inserted preferably in the antecubital fossa. Right side is preferred (when possible) for thoracic or carotid MR angiography•Use respiratory bellows – gating parameters:–R-R intervals = 2-3–Trigger point = 40%–Trigger window = 30%–Delay = minimum•The basic sequences recommended are intended to achieve both anatomic localization and high-quality anatomic imaging to complement the angiographic sequences that are performed. These include:–3-plane localizer–Coronal single-shot fast spin-echo (FSE)–Axial T2 FSE (respiratory triggered)–3D (three-dimensional) contrast-enhanced MR angiography FT (precontrast-practice breath-hold)–3D contrast-enhanced MR angiography FT (postcontrast)–3D contrast-enhanced MR angiography FT (2nd postcontrast)–Axial fast spoiled gradient-echo postcontrast fat-saturated•A power injector is highly recommended with a minimum of 20- to 30-mL saline flush delivered at the same injection rate as the contrast injection•Breath-holding is critical to good image quality for thoracic or abdominal MR angiography. Precontrast or practice scans help ensure that the patient can both breath-hold adequately and understand the instructions•When parallel imaging is used, care must be taken to not have wraparound artifact on the vascular structures. This generally requires prescribing a large field of view beyond the body wall, and for abdominal imaging, it requires placing the arms over the head or elevating the arms at the patient’s side. When performing the calibration scan, overprescribe by one-fourth the area of interest in the superior and inferior directions to reduce scan cutoff. Calibration scans are performed in the axial plane MR Protocols for Central Nervous System (CNS) MR Imaging Newer hardware and software platforms at both 1.5T and 3T allow efficient protocol options for a wide range of CNS indications. This section suggests multiple consensus methods for optimizing examination of patients undergoing MR imaging in the CNS. Core sequences in each protocol are identified, and their aggregate use constitutes a complete examination for each protocol. Alternative sequences of interest are included for emerging technologies, specific target anatomy, or subspecialty preference.1.5T and 3T CNS MR imaging protocols presented here were developed by Howard A. Rowley, MD, Mark C. DeLano, MD, and Megan E. Vadnais, BSRT, (R)(MR) for the following procedures:•Brain–Routine Adult Brain 1.5T and 3T–Brain Neck Magnetic Resonance Angiography (MRA)/Magnetic Resonance Venography (MRV) 1.5T and 3T –Motion Brain 1.5T and 3T–Routine Stroke Fast 1.5T and 3T–Hyperacute Stroke Brain 1.5T and 3T–Tumor Brain 1.5T and 3T–Multiple Sclerosis Brain 1.5T and 3T–Pediatric Brain 1.5T and 3T–Epilepsy Brain 1.5T and 3T•Specialty Brain–Hydrocephalus Brain 1.5T and 3T–Cerebrospinal Fluid Flow 1.5T and 3T–Pituitary 1.5T and 3T–Cranial Nerves/Internal Auditory Canals 1.5T and 3T–Vessel Wall 1.5T and 3T•Head and Neck–Orbits 1.5T and 3T–Soft Tissue Neck 1.5T and 3T–Sinuses/Face 1.5T and 3T•Spine–Cervical Spine 1.5T and 3T–Lumbar Spine 1.5T and 3T–Thoracic Spine 1.5T and 3T–Routine Total Spine 1.5T and 3T–Focused Total Spine 1.5T and 3T–Specialty Spine 1.5T and 3T–Brachial Plexus 1.5T and 3T–Lumbar Plexus 1.5T and 3TGeneral CNS Protocol Notes•Standard brain. There are multiple approaches to obtain various tissue parameter weightings at both1.5T and 3T, such that “standard” imaging refers more to the general-purpose nature of the protocolrather than the core sequence choices. The core preferences of our consensus panel are indicated within each protocol•T1.Six techniques for obtaining T1-weighting are included: spin echo (SE), fast spin echo (FSE), T1 fluid-attenuated inversion recovery (T1-FLAIR), 3D IR-prepared FSPGR (BRAVO), 3D T1 CUBE, and magnetization transfer (MT)–SE is the T1 reference standard for image contrast at 1.5T, although the other sequences have unique advantages and are included as options. Due to T1 prolongation at 3T and associated loss of gray-white contrast there is no consensus standard for T1-weighting, and many sites use inversion recovery preparation to restore tissue contrast–FSE with its intrinsic magnetization transfer effects results in decreased gray-white contrast but may depict contrast enhancement to better advantage–T1-FLAIR and BRAVO are inversion prepared, facilitating excellent gray-white differentiation but with the potential disadvantage of inconspicuous contrast enhancement due to the marked precontrast hypointensity of many lesions and subsequent isointensity to surrounding brain postcontrast –BRAVO, as a standard 3D sequence, has the key advantage of multiplanar reconstruction capability of the isotropic data sets, and excellent gray-white contrast desirable for most applications –T1 CUBE. This T1-weighted FSE-based volumetric sequence can be performed either before or after contrast. Beyond the usual 3D attributes (such as high resolution and multiplanar reconstructions), it has particular advantages postcontrast, where it provides black blood imaging, supports fat saturation, and shows outstanding tissue contrast for enhancing lesions. T1 CUBE is suitable for routine brain imaging and also orbital, cranial nerve, and vessel wall imaging exams. Many sites now use T1 CUBE as a supplement to postcontrast T1 BRAVO and other sequences–MT is an optional feature that can be added to increase contrast enhancement conspicuity on SE imaging, but at the cost of increased SAR and decreased gray-white distinction•T2. Most sites use FSE sequences rather than SE. PROPELLER is effective for dealing with patient motion, and is the primary FSE sequence used at many sites. Some users add fat saturation to T2 imaging as an option•T2-FLAIR.Improves lesion detection particularly at the brain-CSF interface. When done as the first sequence postinjection, postcontrast T2-FLAIR imaging effectively inserts a time delay for subsequent T1-weighted scans, which improves lesion detection on subsequent T1 imaging. The T2-FLAIR images also have some intrinsic T1 contrast that allows visualization of both edema and enhancement on one sequence for many lesions. Both 2D and 3D T2-FLAIR sequences are commonly performed, with the advantage of multiplanar reconstruction capability and fewer CSF pulsation artifacts of the 3D CUBE •Susceptibility. Due to the reduced susceptibility weighting of FSE methods, a T2*-GRE sequence can be added as an option to detect blood products and calcium. The SWAN sequence has been shown to more sensitively detect subtle areas of blood and calcium and has become a common protocol choice•Diffusion. Most brain protocols include a diffusion-weighted imaging sequence that is useful for stroke, infection, and tumor imaging. Apparent diffusion coefficient maps should be included to assess T2 shine-through. In areas near the skull base or orbits, PROPELLER DWI can be a good option to reduce signal pile-up and geometric distortion artifacts•Perfusion. Dynamic susceptibility contrast, perfusion-weighted imaging is becoming increasingly important and can provide clinically significant information regarding blood volume and/or transit time for both stroke and tumor imaging. Arterial spin labeling is also an option for assessing cerebral blood flow at 3T, but must be obtained precontrast•Contrast. The protocols presented here do not list separate imaging sequences for postcontrast imaging; rather, the T1-weighted sequence of choice is typically repeated after contrast agent administration. Most neurologic sequences with contrast are acquired with at least a 3- to 5-minute delay after injection to optimize visualization of disorders of the blood-brain barrier. Some protocols use more than one sequence “family” postcontrast, such as T2-FLAIR, T1-BRAVO, and T1-CUBE Fat Sat due to their complementary information. Many centers prefer routinely acquiring such volumetric series postcontrast to facilitate retrospective multiplanar reconstructions, treatment planning, and neuronavigation applications. T2-FLAIR is an excellent complement to T1 series, and may be done first postcontrast to intentionally provide a time delay before the T1 series are acquired. The method of injection is not important in these cases, and manual injection is typically used. However, power injectors are needed for contrast-enhanced MR angiography and perfusion imaging. Rates of injection vary, but 4 to 5 mL/sec is standard for perfusion, and 1.5 to 2 mL/sec is used for MR angiography. Dosing is weight based and at 0.1 mmol/kg for most protocols aimed at standard extracellular fluid distribution. The dose for an individual injection may be lower for first-pass MRA or perfusion exams, where a split-dose protocol can often be used, keeping overall dose within the standard 0.1 mmol/kg guideline. The ACR has recommended that the lowest dose feasible be used for diagnostic purposes. Because standard dosing recommendations are mostly influenced by lean body mass, and ECF volume in fatty tissues is low, some sites cap the upper limit of contrast for heavier adults at 20 mL total, especially when a high-relaxivity agent is being used.A useful contrast dose calculator (“GadCalc”) is available at https:///contrastCorner/ gadcalc.php and is also available for free download at the Apple and Droid App Stores.。