|
WRIST |
WRIST ARTHROGRAM
|
SHOULDER |
STERNUM |
SHOULDER
ARHTROGRAM |
|
AX Localizer
Axial T2 Fatsat
Coronal T2 Fat Sat
Coronal T1
Coronal 3D GRE
Sagittal T2 NON-FATSAT |
(must do in this order)
Cor T1 FATSAT
Cor T2 FATSAT
Cor GRE 3D(SPGR)
Ax T1 FATSAT
Ax T2 FATSAT-Eliminate
if patient has a recent routine wrist
Sag T1 FATSAT |
3 Plane Loc
Coronal Oblique
T1
Coronal Oblique T2 FSE
Fat Sat
Sagittal Oblique T2 FSE
fat sat
Sagittal Oblique T2 FSE non fat sat
Axial PD fat sat |
Try to position patient prone with saturation band
over mediatinum and with phase direction from side-to-side.
Sag localizer
Cor Oblique T1 through sternum
Cor STIR through sternum
Cor in and out-of-phase
Axial T1
Axial T2 fat sat.
Sagittal PD non fat sat
|
3 Plane Loc
cor T1 fat sat
ax T1 fat sat
sag T1 fat sat
cor T2 fat sat
sag T2 NON-FATSAT
|
|
ELBOW |
THUMB |
BRACHIAL
PLEXUS |
BONY PELVIS |
SI JOINTS |
Image anatomy with ulna/radius directed inferiorly on
films
30 min slot
Coronal Localizer
Axial T2 FATSAT
Axial T1
Cor STIR
Cor PD NON fat sat
Sagittal T2 FATSAT
|
Axial T1
Axial T2 fs
Cor PD
Cor T2 fs
Sag T2 fs |
Ax
Localizer
Coronal T1 bilaterally
Axial T2 SSFSE Fat Sat affected side only, angled parallel
to subclavian vein
Axial T1 SPGR affected side only, angled parallel to
subclavian vein
Coronal T2 Fat Sat affected side only
Coronal T1 affected side only
Sag T1 affected side only
Check with rad if Gad
needed |
Axial T1
Axial T2 Fat Sat
Coronal T1 (include from pubic
symphysis to sacrum)
Coronal STIR
Coronal In/Out of phase
|
Axial T1
Axial T2 fat sat
Coronal Oblique T1
Coronal Oblique STIR
Check with radiologist for post gad
sequences
|
|
HIP |
Screening HIP
Fracture |
HIP
ARTHROGRAM |
SACRUM or
COCCYX |
KNEE |
|
3 Plane Loc
Coronal T1 - entire pelvis
Coronal STIR– entire pelvis
Axial PD NON-FATSAT through painful hip
- Obtain as
AXIAL OBLIQUE if <45
years of age and indication = pain of unknown origin
Sag T2 Fat Sat of painful hip – Reduce
FOV 16-18 |
3 Plane Loc
Coronal T1 - entire pelvis
Coronal STIR– entire pelvis
Axial T2 FATSAT through painful hip
Sag T2 NON FATSAT of painful hip –
Reduce FOV 16-18 |
Cor Localizer
Sag T1 FATSAT
Ax OBLIQUE T1 FATSAT
Cor T1 NON- FATSAT
Cor STIR entire pelvis |
Cor T1
Cor STIR
Cor in- and out-phase
Sag T1
Sag T2 fatsat |
Ax localizer
Sag PD FSE FATSAT
Cor T1
Cor PD FSE FATSAT
Ax T2 FSE FATSAT -TE 60 |
|
ACL
GRAFT |
DIRECT KNEE
ARTHROGRAM |
INDIRECT KNEE
ARTHROGRAM |
ANKLE,
ROUTINE |
FOOT |
|
axial T2 non fat sat
sag PD fat sat
cor T2 non fat sat
cor PD fat sat (or STIR if there is artifact
from graft) |
axial T1 Fat sat
sag T1 Fat sat
cor T1 Fat sat
sag T2 Fat sat
cor T2 FSE NON FATSAT |
Inject contrast exercise knee wait 20 min., then proceed
with scanning
axial T1 Fat sat
sag T1 Fat sat
cor T1 Fat sat
sag T2 Fat sat
cor T2 FSE NON FATSAT |
Coronal Localizer
Sagittal T1
Axial T2 fat sat
Axial PD NON fat sat
Coronal T2 Fat Sat
|
Optimize FOV to evaluate area of interest.
For example, if study is to r/o Morton’s neuroma, scan
forefoot
30 min slot
3Plane Loc
Axial T2 NON fat sat
Cor T1 - Cucumber
slices
Cor T2 fat sat
-Cucumber slices
Sag T1
Sag Stir |
|
R/O
OSTEOMYELITIS
(forefoot) &
MORTON’S NEUROMA |
SOFT TISSUE
MASS IN EXTREMITY |
METAL
PROTOCOL |
LUMBOSACRAL
PLEXUS |
RA WRISTS
/ HANDS |
|
coronal T1
coronal T2 fat sat
sagittal T1
sagittal STIR
coronal SPGR fat sat pre and post-gad
sagittal and axial SPGR fat sat post-gad
|
If mass is located anterior or posterior aspect of the
extremity, use a Sagittal sequence. If mass is located
medial or lateral, use a Cor
Axial T1
Axial T1 Fatsat
Axial T2
Cor or Sag T2 FATSAT
Axial, Cor and Sag post T1 Fatsat
|
NO GRE
Change FATSAT to STIR
Consider GAD
Decrease FOV
Increase Matrix
Increase BW |
Acrobat document link |
Prayer position with patient
prone arms overhead or lateral supine. Use flexible coil or
extremity coil. Pad between hands. Inject first, and
obtain in this order:
Coronal SPGR fat sat post-contrast
Coronal T2 fat sat
Axial SPGR fat sat post-contrast |
