Body MRI Protocol

BODY MRI PROTOCOLS
Updated
1/30/2019
Abdomen Pelvis
Limited Abdomen and Pelvis MRCP Anal Fistula Prostate Cancer Staging
Basic (limited) Abdomen Pancreas Routine Female Pelvis Dynamic (multiparametric) Prostate
Basic (limited) Pelvis Adrenal Female Pelvis Mullerian Appendicitis Pregnant
Dynamic Liver Renal Mass Cervical CA Staging Defecography
Eovist Liver Urogram Endometrial Cancer Rectal Cancer
Liver for Hemochromatosis Enterography Urethral
MRA/MRV Other
Renal MRA Aorta (CAP) MRA MRV Pelvis DVT Chest - general
Mesenteric MRA
1
Limited Abdomen and Pelvis
(Cancer surveillance, non-specific clinical history)
Axial In/Out Phase Pelvis
Axial T2 FS Pelvis
Axial 3D VIBE FS Pre Pelvis
Axial In/Out Phase Abdomen
Axial T2 Abdomen
Coronal T2 Abdomen/Pelvis
Axial 3D VIBE FS Pre Abdomen
Axial 3D VIBE FS Post Abdomen (arterial)
Axial 3D VIBE FS Post Abdomen (venous)
Axial 3D VIBE FS Post Pelvis
Coronal 3D VIBE FS Abdomen/Pelvis
FOV MATRIX PHASE SCAN

Sequence TR TE SLICE GAP NEX OTHER
FREQ PHASE PHASE FREQ DIR DIR
1.2
AX IN/OUT PHASE PEL 170 and 380 80% 5 1 256 256 A/P 1 S->I
2.4
AX T2 FS PELVIS 1600 95 380 80% 5 1 192 320 A/P 1 S->I
AX VIBE PELVIS 4.3 1.89 380 80% 3 0.6 320 190 A/P 1 S->I
1.2
AX IN/OUT PHASE ABD 170 and 380 80% 5 1 256 256 A/P 1 S->I
2.4
AX T2 ABD 1600 95 380 80% 5 1 194 320 A/P 1 S->I
COR T2 ABD/PELVIS 1400 91 440 100% 5 1 320 320 R/L 1 P->A
AX VIBE FS PRE ABD 4.3 1.89 380 80% 3 0.6 194 320 A/P 1 S->I
AX VIBE FS POST
4.3 1.89 380 80% 3 0.6 194 320 A/P 1 S->I
ABD(ARTERIAL/VENOUS)
AX VIBE FS POST PELVIS 4.3 1.89 380 80% 3 0.6 194 320 A/P 1 S->I
COR VIBE FS POST ABD/PEL 4.3 1.89 440 100% 3 0.6 194 320 R/L 1 P->A
2
Basic Abdomen
(Abscess, non-specific clinical history, non-organ evaluation)
Coronal T2
Axial T2 FS
Axial In/Out Phase
Axial 3D VIBE FS Pre
Coronal 3D VIBE FS Pre
Axial 3D VIBE FS Post Arterial
Coronal 3D VIBE FS Post Delayed

COR T2 1400 91 440 100% 5 1 320 320 R/L 1 P->A
AX T2 FS 1600 95 380 80% 5 1 194 320 A/P 1 S->I
1.2
AX IN/OUT PHASE 170 and 380 80% 5 1 256 256 A/P 1 S->I
2.4
AX VIBE FS PRE 4.3 1.89 380 80% 3 0.6 194 320 A/P 1 S->I
COR VIBE FS PRE 4.0 1.74 400 100% 3 0.6 256 320 R/L 1 P->A
AX VIBE FS POST
4.3 1.89 380 80% 3 0.6 194 320 A/P 1 S->I
(arterial)
COR VIBE FS POST 4.0 1.74 400 100% 3 0.6 256 320 R/L 1 P->A
3
Basic Pelvis
(Abscess, non-specific clinical history)
Axial T2 FS
Axial In/Out Phase
Axial 3D VIBE FS Pre
Coronal 3D VIBE FS Pre
Axial 3D VIBE FS Post
Coronal 3D VIBE FS Post

AX T2 FS 1600 95 380 80% 5 1 194 320 A/P 1 S->I
1.2
AX IN/OUT PHASE 170 and 380 80% 5 1 256 256 A/P 1 S->I
2.4
AX VIBE FS PRE 4.3 1.89 380 80% 3 0.6 194 320 A/P 1 S->I
COR VIBE FS PRE 4.0 1.74 400 100% 3 0.6 256 320 R/L 1 P->A
AX VIBE FS POST 4.3 1.89 380 80% 3 0.6 194 320 A/P 1 S->I
COR VIBE FS POST 4.0 1.74 400 100% 3 0.6 256 320 R/L 1 P->A
4
Dynamic Liver
(HCC, Cholangiocarcinoma, lesion characterization)
Coronal T2
Axial T2 BH
Axial T2 FS BH
Axial IN/OUT PHASE
Axial 3D VIBE FS PRE
Axial 3D VIBE FS POST
(30 SEC/1 MIN/3 MIN)
*with subtractions
Coronal 3D VIBE FS POST
(5 MIN)
Axial DIFFUSION (b value 50, 400, and 750)
Need ADC maps
FOV Slice Matrix
Gap Phase Scan
Sequence TR TE Phase Thickness NEX OTHER
Frequency (mm) Phase Frequency Direction Direction
% (mm)
COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A
AXIAL T2 1600 95 380 75 5 1 194 320 A/P 1 S->I
AXIAL T2 FS 1600 95 380 75 5 1 194 320 A/P 1 S->I
1.2/2.4 (3T)
AXIAL IN/OUT
170 2.2/4.4(1.5T) 380 75 5 1 256 256 A/P 1 S->I
PHASE
AXIAL VIBE FS
4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
PRE
AXIAL VIBE FS
4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
POST
COR VIBE FS
4 1.7 400 100 3 0.6 240 320 R/L 1 P->A
POST
AXIAL B VALUE:
5800 61 380 80 5 1 160 190 A/P NA S->I
DIFFUSION 50/400/750
5
Eovist Liver
(R/O mets, if FNH/adenoma suspected, biliary leaks)
Coronal T2
Axial T2
Axial T2 FS
Axial IN/OUT PHASE
Axial 3D VIBE FS
(2 phase arterial/1 MIN/3 MIN)
Coronal 3D VIBE FS POST (4 MIN)
Axial 3D VIBE FS POST (5 MIN)
Axial 3D VIBE FS POST (20 MIN)
Coronal 3D VIBE FS POST (20 MIN)
*with subtractions
FOV: Slice Matrix:
Gap Phase Scan
% (mm)
COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A
AXIAL T2 1600 95 380 75 5 1 194 320 A/P 1 S->I
AXIAL T2 FS 1600 95 380 75 5 1 194 320 A/P 1 S->I
1.2/2.4 (3T)
AXIAL IN/OUT
170 2.2/4.4(1.5T) 380 75 5 1 256 256 A/P 1 S->I
PHASE
AXIAL VIBE FS
4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
PRE
AXIAL VIBE FS
4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
POST
COR VIBE FS
4 1.7 400 100 3 0.6 240 320 R/L 1 P->A
POST
6
Liver for Hemochromatosis
1.5T Preferred – DHMC Siemens Aera (Scanner 3) ONLY
Coronal T2
Axial T2
Axial Multi Echoes Apnee Body 20°
No multi-element coil - body coil only
3-5 slices through the liver and spleen
Coverage for Multi Echo Apnee Body 20°

No multi-element coil (body coil only)
Limited Coverage: 3-5 slices through liver and
spleen

Cor T2 1600 91 440 100% 5 1 320 320 R/L 1 P->A Whole Liver
Ax T2 1600 95 380 75% 5 1 194 320 A/P 1 S->I Coverage
Axial Multi Echoes No multi-
120 380 85% 10 2 192 256 A/P 1 S->I element coil
Apnee Body 20° (1.5T) *Multi TE
(body coil only)
Values
Limited
Axial Multi Echoes (see note Coverage – 3-5
120 above) 408 85% 7 8 128 128 A/P 1 S->I
Apnee Body 20° (3T) slices through
liver and spleen
7
MRCP
(Patient prep: NPO 4 hours prior. Arrive 20-30 min early for 150-300ml of PO pineapple juice)
Coronal T2
Axial T2
THICK SLAB SSFSE – 3 OBLIQ PLANES THROUGH PANC/CBD/GB 40MM THICK
Coronal 3D VOLUME RESPIRATORY TRIGGERED MRCP*
1. THIN COR MIP IMAGES CREATED FROM THIS 1.6/ 0.8
2. THIN AX MIP CREATED FROM THIS 1.6/0.8
*DO BREATH HOLD COR 3D ACQUISITION IF THE RESPIRATORY TRIGGER IS POOR
IF SECRETIN EXAM:
*SECRETIN: ADULT: 0.2µg/kg IV SLOWLY PUSHED OVER 1 MINUTE
PEDIATRIC: 0.2µg/kg (MAX DOSE 16 µg)
*ADMINISTERED BY ANGIO RN – IV PUSH
THICK SLAB SSFSE THROUGH PLANE OF PANCREATIC DUCT EVERY MINUTE FOR 10 MINUTES (STACKED)
THICK SLAB ANGLES
THICK SLAB:
Coronal and Coronal Oblique x2 Axial Coverage
8
MRCP continued
FOV: Slice Matrix:

Gap Phase Scan
Frequency (mm)
(mm) Phase Frequency Direction Direction
%
COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A
AXIAL T2 1600 95 380 75 5 1 194 320 A/P 1 S->I
COR THICK
4500 735 300 100 50 25 269 384 L/R 1 P->A
SLAB
COR OBLIQ
4500 735 300 100 50 25 269 384 P/A 1 P->A
SLAB
COR OBLIQ
4500 735 300 100 50 25 269 384 P/A 1 P->A
SLAB
COR 3D RESP
5800 698 380 100 1 0 376 384 R/L 1.7 P->A
TRIGGERED
COR 3D
2000 697 380 100 1 .5 256 320 R/L 1.4 P->A
BREATH HOLD
If Secretin used
COR THK SLAB
4500 735 300 100 50 25 269 384 P/A 1 P->A RUN X 10
POST SECRETIN
9
Pancreas – IPMP F/U
Patient Prep: NPO for 4 hours
If MRCP is NOT requested, give 750mL water (PO) starting 60 minutes prior to exam
Coronal T2
Axial T2
Axial T2 FS
Axial IN/OUT PHASE
(35 SEC/70 SEC/3 MIN)
Slice thickness 3mm
(3 MIN)
FOV: Slice Matrix:

Gap Phase Scan
Frequency (mm)
%
COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A
AXIAL T2 1600 95 380 75 3 1 192 320 A/P 1 S->I
AXIAL T2 FS 1600 95 380 75 3 1 194 320 A/P 1 S->I
1.2/2.4 (3T)
AXIAL IN/OUT
170 2.2/4.4(1.5T) 380 75 5 1 256 256 A/P 1 S->I
PHASE
AXIAL VIBE FS
4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
PRE
AXIAL VIBE FS
4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
POST
COR VIBE FS
4 1.7 400 100 3 0.6 240 320 R/L 1 P->A
POST
10
Adrenal
If indication is adrenal adenoma, call rad to check after IN/OUT phase series
Coronal T2: diaphragm to aortic bifurcation
Axial IN/OUT PHASE Adrenals
Coronal IN/OUT PHASE Adrenals
Axial T2 FS: diaphragm to aortic bifurcation
Axial 3D VIBE FS PRE: diaphragm to aortic bifurcation
Axial 3D VIBE FS POST: diaphragm to aortic bifurcation
(35 SEC/70 SEC)
(3 MIN)
FOV: Slice Matrix:

Gap Phase Scan
% (mm)
COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A
1.2/2.4 (3T)
AXIAL IN/OUT
170 2.2/4.4(1.5T) 380 75 4 1 256 256 A/P 1 S->I
PHASE
1.2/2.4 (3T)
COR IN/OUT
170 2.2/4.4(1.5T) 380 75 4 1 256 256 A/P 1 S->I
PHASE
AXIAL T2 FS 1600 95 380 75 5 1 194 320 A/P 1 S->I
AXIAL VIBE FS PRE 4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
AXIAL VIBE FS
4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
POST
COR VIBE FS POST 4 1.7 400 100 3 0.6 240 320 R/L 1 P->A
11
Renal Mass
FOV limited to kidneys
Coronal T2
Axial T2
Axial T2 FS
Axial IN/OUT PHASE
Axial 3D VIBE PRE
Coronal 3D VIBE FS PRE
(25 SEC/90 SEC) *with subtractions
Axial 3D VIBE FS POST *with subtractions
**If patient cannot receive gadolinium**
Axial DIFFUSION X2 (b value of 50 and 750) and ADC maps
FOV: Slice Matrix:

Gap Phase Scan
% (mm)
COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A
AXIAL T2 1600 95 380 75 5 1 194 320 A/P 1 S->I
AXIAL T2 FS 1600 95 380 75 5 1 194 320 A/P 1 S->I
AXIAL IN/OUT 1.2/2.4 (3T)
170 380 75 5 1 256 256 A/P 1 S->I
PHASE 2.2/4.4(1.5T)
COR VIBE FS PRE 4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
COR VIBE FS POST 4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
AX VIBE FS POST 4 1.7 400 100 3 0.6 240 320 R/L 1 P->A
B VALUE:
AXIAL DIFFUSION 5800 61 380 80 5 1 160 190 A/P NA S->I
50/400/750
12
Urogram
Patient Prep: Arrive 1 hour prior to get IVF
Empty bladder prior to getting on table
Adult: 500mL NS bolus immediately before scan
Pediatric: weight based IVF:
4mL/kg/hr. 1st 10kg
2mL/kg/hr. next 10kg
1mL/kg/hr. for each kg above 20kg
Adults: arrive 1 hour prior to angio for IV placement, fluids, possible catheter placement (optional)
*Lasix dose: 20-40mg slow IV push
Pediatrics: Requires Pain Free and catheter (can administer Lasix)
*Lasix dose: 1mg/kg (up to max dose 20mg) slow IV push
Coronal T2 FS Abdomen/Pelvis
Axial T1 FS Abdomen/Pelvis
Axial T2 Abdomen/Pelvis
Axial T2 FS Abdomen/Pelvis
**Inject Lasix**
Coronal T2 Thick Slab (straight coronal)
Coronal T2 Thin (1mm) Respiratory Triggered Kidneys/Ureters
- Need 3D reconstructions + Thin Axial Reformats 1mm
- Coronal oblique plane to include kidneys and bladder (2mm slice thickness)
- Arterial (~30 sec), 100 SEC (nephrographic), 8 MIN (excretory)
- Automatic MIP images of each volume acquired
**Have Radiologist Check**
Coronal 3D VIBE FS POST 10 MIN (need to see ureters to bladder)
13
Urogram continued
FOV: Slice Matrix:

Gap Phase Scan
Sequence TR TE Thickness NEX OTHER
Frequency Phase % (mm) Phase Frequency Direction Direction
(mm)
COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A
COR T2 FS 1600 91 440 100 5 1 320 320 R/L 1 P->A
AXIAL T1 FS 572 20 380 75 5 1 256 192 A/P 2 S->I

AXIAL T2 1600 95 380 75 5 1 194 320 A/P 1 S->I
AXIAL T2 FS 1600 95 380 75 5 1 194 320 A/P 1 S->I
420 Straight
COR T2 THK Slabs 4500 564 80 50 0 218 384 S/I 1 P->A
Coronal
COR T2 Thin
2400 698 380 100 1.0 384 384 R/L 1.7 P->A
RESP TRIG
COR VIBE FS PRE
30 SEC (Arterial),
100 SEC
4.3 1.8 400 80 2 0.4 190 320 A/P 1 S->I
(Nephrographic),
8 MIN
(Excretory)
COR VIBE FS POST 4.3 1.8 400 80 2 0.4 190 320 A/P 1 S->I
14
Enterography
Patient prep: Volumen, 3 bottles, 90 minutes prior
Glucagon – 0.5 mg IM after CISS
Coronal T2 CISS
**HAVE IMAGES CHECKED BY RADIOLOGIST**
*Have RN inject glucagon
Coronal T2 BH
Axial T2 BH
Axial T2 FS BH

Coronal T2 CISS 186 1.15 430 100 5.5 0 169 224 R->L 1 P->A
**Check for Glucagon**
Coronal T2 1600 91 440 100 5 1 320 320 R/L 1 P->A
AX T2 1600 95 380 75 5 1 194 320 A/P 1 S->I
AX T2 FS 1600 95 380 75 5 1 194 320 A/P 1 S->I
AX VIBE FS PRE 4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
COR VIBE FS PRE 4 1.7 440 100 3 0.6 240 320 R/L 1 P->A
COR VIBE FS POST
4 1.7 440 100 3 0.6 240 320 R/L 1 P->A
(35 and 70 sec)
AX VIBE FS Post 4.3 1.8 380 80 3 0.6 190 320 A/P 1 S->I
15
RENAL MRA
Coronal T2
To determine anatomy and location of kidneys
Axial T2 FS BH
Coronal TRICKS POST
- Reformat into thin axial and coronal
- 3D reformats of arterial phase
Coronal 3D VIBE FS 5 MIN Post
3D PC (IF GAD NOT GIVEN)
FOV: Slice Matrix:

Gap Phase Scan
(mm)
COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A
AX T2 FS 1600 95 380 75 5 1 194 320 A/P 1 S->I
AX VIBE FS PRE/POST 4.3 1.89 380 81.3 3 1 190 320 A/P 1 S->I
COR TRICKS POST 2.98 1.06 380 100 1.10 0 213 320 R/L 1 P->A
COR VIBE FS 5 MIN

4 1.74 400 100 3 1 240 320 R/L 1 P->A
Post
3D PC 38.3 5.6 320 90 .90 1 192 256 R/L 1 S->I
16
MESENTERIC MRA
Coronal T2
Axial T2 FS BH
Sagittal Angio3D PRE
Sagittal TRICKS
- Reformat into thin axial and sagittal
Coronal 3D VIBE FS 5 MIN Post
FOV: Slice Matrix:

Gap Phase Scan
(mm)
COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A
AX T2 FS 1600 95 380 75 5 1 320 194 A/P 1 S->I
AX VIBE
4.3 1.89 380 81.3 3 1 320 190 A/P 1 S->I
PRE/POST
SAG TRICKS 2.98 1.06 380 100 1.10 0 320 213 R/L 1 P->A
COR VIBE 5 MIN

4 1.74 400 100 3 1 320 240 R/L 1 P->A
Post
17
AORTA (CAP) MRA
If patient cannot get gadolinium – must be done on 3T
Axial DIR (PERIPHERAL GATED)

Axial T2 CISS (PERIPHERAL GATED)
Sagittal OBL CINE GRE (PERIPHERAL GATED)
Axial VIBE PRE
Sagittal Oblique (Candy Cane) TRICKS
- Reformat into thin axial and sagittal
Angle for sagittal oblique (candy cane)
FOV: Slice Matrix:

Gap Phase Scan
% (mm)
AX DIR 750 27 380 81.3 8 2 256 256 A/P 1 S->I
AX T2 CISS 3.58 1.57 380 81.3 5 0 320 208 A/P 1 L->R
AX VIBE FS
4.3 1.89 380 81.3 3 1 320 190 A/P 1 S->I
PRE/POST
SAG OBL
2.98 1.06 380 100 1.10 0 320 213 R/L 1 P->A
TRICKS
18
Anal Fistula
Should be performed on 3T
Sagittal T2 (Full FOV, 2.5mm/gap 0mm)
*Use to establish oblique planes –
Axial and coronal to long axis of anal canal
MD to check planes if unsure
Small FOV (26cm):
Axial Oblique T1 (4mm/0.8)
Axial Oblique T2 FS (4mm/0.8)
Axial Oblique T2 (4mm/0.8)
Coronal Oblique T2 FS (4mm/0.8)
Coronal Oblique T2 (4mm/0.8)
Axial Oblique VIBE FS Pre
Axial Oblique VIBE FS Post
Coronal Oblique VIBE FS Post
FOV: Slice Matrix:
Gap Phase Scan
(mm)
SAG T2 2570 92 300 100 2.5 0 384 384 S/I 3 L->R
AXIAL OBL T1 527 20 260 100 4 0.8 240 320 R/L 2 S->I
Coverage
AXIAL OBL T2 FS 3000 86 260 100 4 0.8 272 320 R/L 2 S->I
should
AXIAL OBL T2 3000 86 260 100 4 0.8 272 320 R/L 2 S->I include the
86 entire anal
COR OBL T2 FS 3000 260 100 4 0.8 272 320 R/L 2 P->A
canal
86
COR OBL T2 3000 260 100 4 0.8 272 320 R/L 2 P->A through the
AX VIBE FS PRE 7.4 3.8 260 80 3 0.6 190 320 A/P 4 S->I soft tissue of
the buttocks
AX VIBE FS POST 7.4 3.8 260 80 3 0.6 190 320 A/P 4 S->I
COR VIBE FS
7.2 3.8 260 100 3 0.6 240 320 R/L 4 P->A
POST
19
MRV Pelvis DVT
2D TOF – reformat into 3D image

Sat band should be placed superior to the FOV to null arterial flow
Axial VIBE FS Pre
3D MRV Pre (dry run)
3D MRV Post: Scan in 3 phases
(2min/3min/4min)
Reformat each phase into axial and sagittal
3D Coronal MIP of each phase
Axial VIBE FS Post
FOV: Slice Matrix:

Gap Phase Scan
Sequence TR TE Phase
Thickness NEX OTHER
% (mm)
2D TOF 458 3.7 350 50 3.5 -27 320 320 A->P 1 S->I
AX VIBE FS Pre 6.19 2.39 340 100 3 1 320 240 R->L 4 S->I
3D MRV Post 3.08 1.11 320 320 1 1 320 262 R->L 1 P->A
AX VIBE FS Post 6.19 2.39 340 100 3 1 320 240 R->L 4 S->I
20
Routine Female Pelvis
Adenomyosis, fibroids, adnexa
Planes in relation to the uterus for uterine pathology, otherwise in relation to pelvis
AXIALS
Axial T1 whole pelvis
Small FOV:
Axial T1 FS (superior and inferior sat bands)
Axial T2
Axial T2 FS
Sagittal T2 (uterine evaluation)
Sagittal T2 FS
*OPTIONAL WITH CONTRAST CORONALS
Axial VIBE FS Pre
Axial VIBE FS Post
Coronal VIBE FS Post
Sagittal VIBE FS Post
FOV Slice Matrix
Gap Phase Scan
(mm)
COR T2 1400 91 440 100 5 1 320 320 R->L 1 s->I ABD/PEL
AX T1 455 20 300 100 5 1 320 256 R->L 1 S->I Whole Pelvis

AX T1 FS 582 21 200 100 5 1 320 240 R->L 2 S->I
AX T2 5370 91 200 100 5 1 320 272 R->L 2 S->I
AX T2 FS 3000 91 200 100 5 1 320 272 R->L 2 S->I
SAG T2 5160 91 220 100 5 1 320 272 A->P 3 R->L

SAG T2 FS 3000 91 220 100 5 1 320 272 A->P 3 R->L
AX VIBE FS Pre 6.47 2.65 240 100 3 1 320 240 A->P 4 S->I
AX VIBE FS Post 6.47 2.65 240 100 3 1 320 240 A->P 4 S->I
COR VIBE FS Post 4.42 1.46 240 109.4 2 1 320 245 R->L 2 A->P
Sag VIBE FS Post 4.42 1.46 240 100 2 1 320 245 A->P 2 R->L
21
Female Pelvis Mullerian
CALL RADIOLOGIST TO CHECK ANGLES FOR SCANNING
AXIALS
Axial T2 FS Full FOV
Axial T1 Full FOV
Coronal T2 Full FOV to include kidneys (7mm slice)
Small FOV in relation to the uterus:
Sagittal T2 (4mm slice)
Axial T2 (4mm slice)
Coronal T2 (4mm slice)
CORONALS
FOV Slice Matrix:

Gap Phase Scan
% (mm)
AX T2 FS 3450 96 300 100 5 1 320 310 A->P 2 S->I Whole

AX T1 455 20 300 100 5 1 320 256 R=>L 1 S->I Pelvis
COR T2 1400 91 440 100 5 1 320 320 R->L 1 A->P Full FOV
SAG T2 4960 220 100 4 1 320 256 A->P 3 R->L

91
AX T2 4960 91 200 100 4 1 320 272 R->L 2 S->I
COR T2 4960 91 200 100 4 1 320 272 R->L 2 A->P
22
Cervical Cancer Staging
Planes for small FOV axial images in relation to the cervix
Axial T1 Abdomen/Pelvis
Axial T2 FS Full FOV Pelvis
Sagittal T2 small FOV pelvis
Axial Oblique (SAX) T2 small FOV Cervix
LAX to the cervix

SAX to the cervix
FOV: Slice Matrix:

Gap Phase Scan
% (mm)
AX T1 4.3 1.89 380 81 3 190 320 A/P 1 S->I ABD/PEL

AX T2 FS 3400 96 300 100 5 1 310 320 A/P 2 S->I Full Pelvis
SAG T2 4900 86 240 100 5 1 256 320 A/P 3 L->R
SAX T2 4900 91 200 100 5 1 272 320 R/L 2 S->I
23
Endometrial Cancer
Planes for small FOV axial/coronal images in relation to the uterus
Large FOV:
Axial T1 upper abdomen and pelvis
Axial T2 FS Pelvis full FOV
Small FOV:
Sagittal T2 Small FOV
Axial OBL (SAX of the uterus) T2
Axial OBL (SAX) VIBE PRE
Sagittal VIBE FS PRE
Sagittal VIBE FS POST (1 MIN/3 MIN/5 MIN)
Axial OBL (SAX) VIBE FS POST (4 MIN)
LAX to the uterus

SAX to the uterus
FOV: Slice Matrix:

Gap Phase Scan
% (mm)
ABD/PEL
AX T1 4.30 1.89 380 81 3 190 320 A/P 1 S->I
64 slabs
AX T2 FS 3450 96 300 100 5 1 310 320 A/P 2 S->I Full Pelvis
SAG T2 500 96 220 100 5 1 256 320 A/P 3 L->R
AX OBL (SAX) T2 4900 96 200 100 5 1 272 320 R/L 2 S->I
AX OBL (SAX)
4.3 2.08 240 100 3 0.6 240 320 R/L 1 S->I
VIBE FS PRE
SAG VIBE FS PRE 4.51 2.19 240 81 3 0.6 190 320 A/P 1 L->R
SAG VIBE FS POST 4.51 2.19 240 81 3 0.6 190 320 A/P 1 L->R
AX OBL (SAX)
4.3 2.08 240 100 3 0.6 240 320 R/L 1 S->I
VIBE FS PRE
24
Female Pelvis - Urethral
Coronal T2 (wide FOV to include kidneys)
Small FOV (18cm-24cm) centered at urethra:
Axial T2 FS
Sagittal T2 FS
Coronal T2 FS
If indicated (requested by the MD for infection, inflammation, or malignancy):
Axial VIBE FS PRE
Axial VIBE FS POST
Sagittal VIBE FSPOST
Coronal VIBE FS POST
FOV: Slice Matrix:

Gap Phase Scan
% (mm)
COR T2 1800 95 440 100 5 1 320 320 R/L 1 P->A Full FOV
AXIAL T2 FS 3000 91 200 100 3 1 272 320 R/L 3 S->I
SAG T2 FS 3000 86 220 100 3 1 224 320 A/P 4 L->R
COR T2 FS 3000 86 220 100 3 1 224 320 R/L 4 P->A
AXIAL VIBE FS PRE 4.8 2.19 240 100 3 240 320 A/P 4 S->I
AXIAL VIBE FS
4.8 2.19 240 100 3 240 320 A/P 4 S->I
POST
SAG VIBE FS POST 3.19 1.46 240 100 2 245 320 A/P 2 L->R
COR VIBE FS POST 3.19 1.46 240 100 2 245 320 R/L 2 P->A
25
Pelvis Penile Tumor (Male Urethral)
Axial T1 Large FOV
Axial T2 Small FOV
Coronal T2 Small FOV
Axial T2 FS Small FOV
Axial T1 In/Out Phase
Axial DWI
Axial VIBE FS PRE
Patient positioning: Patient is imaged in a supine position. To elevate the scrotum and penis, a folded
Axial VIBE FS POST towel is placed between the patient’s legs. The penis is taped to the abdomen in a dorsi-flexed position
Sagittal VIBE FS POST to prevent movement and pulsation artifacts. A surface coil is placed on the penis to improve signal-to-
noise ratio. Small FOV Imaging planes are in axis with the penis.
FOV: Slice Matrix:
Gap Phase Scan
Sequence TR TE Phase Thickness
(mm) Direction
NEX
Direction OTHER
Frequency (mm) Phase Frequency
%
LG FOV –
AX T1 400 11 340 100 5 1 192 256 A/P 1 S->I Axial to the
body
AXIAL T2 3000 91 160 100 4 0.5 256 256 R/L 3 S->I SM FOV
Angled to the
SAG T2 3000 86 160 100 4 0.5 256 256 A/P 4 L->R axis of the
COR T2 3000 86 160 100 4 0.5 256 256 S/I 4 P->A penis
(Interpolation
AX T2 FS 3000 91 160 100 4 0.5 256 256 R/L 3 S->I or Zip512)
1.2/2.4 (3T)
Ax In/Out Phase 170
2.2/4.4(1.5T)
340 100 4 1 192 256 A/P 1 S->I
Ax DWI 8500 95 340 100 8 2 128 128 A/P 1 S->I LG FOV –
AXIAL VIBE FS Axial to the
4.8 2.19 340 100 3 0 256 320 A/P 4 S->I
PRE body
AXIAL VIBE FS
4.8 2.19 260 100 3 0 256 320 A/P 4 S->I
POST
SAG VIBE FS
3.19 1.46 260 100 3 0 192 256 A/P 2 L->R
POST
26
Pelvis Penile Trauma/Inflammation
Axial T1 Large FOV
Axial T2 Small FOV
Coronal T2 Small FOV
Sag T2 FS Small FOV
Axial T1 In/Out Phase
Axial DWI
If Contrast Add:
Axial VIBE FS PRE
Patient positioning: Patient is imaged in a supine position. To elevate the scrotum and penis, a folded towel is placed between
Axial VIBE FS POST
the patient’s legs. The penis is taped to the abdomen in a dorsi-flexed position to prevent movement and pulsation artifacts. A
Sagittal VIBE FS POST surface coil is placed on the penis to improve signal-to-noise ratio. Small FOV Imaging planes are in axis with the penis.
FOV: Slice Matrix:

Gap Phase Scan
Sequence TR TE Thickness
(mm) Direction
NEX
Direction OTHER
Frequency Phase % (mm) Phase Frequency
LG FOV –
AX T1 400 11 340 100 5 1 192 256 A/P 1 S->I Axial to the
body
AXIAL T2 3000 91 160 100 4 0.5 256 256 R/L 3 S->I SM FOV
Angled to the
SAG T2 3000 86 160 100 4 0.5 256 256 A/P 4 L->R axis of the penis
(Interpolation or
COR T2 3000 86 160 100 4 0.5 256 256 S/I 4 P->A
Zip512)
SAG T2 FS 3000 91 160 100 4 0.5 192 256 S/I 4 L->R Trauma
1.2/2.4 (3T)
Ax In/Out Phase 170
2.2/4.4(1.5T)
340 100 4 1 192 256 A/P 1 S->I Trauma
Ax DWI 8500 95 340 100 8 2 128 128 A/P 1 S->I Inflammation
AX T2 FS 3000 91 340 100 6 1 256 320 R/L 3 S->I Inflammation
AXIAL VIBE FS
4.8 2.19 340 100 3 0 256 320 A/P 4 S->I LG FOV –
PRE
Axial to the
AXIAL VIBE FS
4.8 2.19 340 100 3 0 256 320 A/P 4 S->I body
POST
27
Prostate Cancer Staging
For staging or XRT planning
Set angles straight to the pelvis and cover prostate and seminal vesicles
Axial T1 whole pelvis

Small FOV:
Axial T1
Axial T2 (3mm slice)
Sagittal T2 (3mm slice)
Coronal T2 (3mm slice)
Axial 3D T2
FOV: Slice Matrix:

Gap Phase Scan
% (mm)
Ax T1 455 20 300 100 5 1 320 256 R->L 1 S->I
Ax T1 626 13 200 100 5 1 256 100 R->L 1 S->I
Ax T2 3000 91 200 100 3 0 320 256 R->L 3 S->I
Sag T2 3000 91 200 100 3 0 320 256 H->F 3 R->L
Cor T2 3000 91 220 100 3 0 320 256 R->L 3 P->A
98
Ax 3D T2 1700 320 100 2 0 320 291 R->L 1.4 S->I
28
Dynamic Prostate (Multiparametric)
Elevated PSA, negative biopsy
Must be done on 3T/phased array body coil
Cover entire prostate and seminal vesicles
Axial T1 FSE TR/TE 650/10 small FOV (20cm) 3mm/1mm MATRIX 320
Axial T2 small FOV (20cm) 3mm/1mm MATRIX 320
Sagittal T2 small FOV FSE 3mm/1mm
Coronal T2 5000/93 Echo train 13 small FOV (20cm) 3mm/1mm MATRIX 320
DWI axial TR/TE 6000/78 flip angle 90, NEX 6, b-values 100, 500, and 800 matrix 128x92 FOV 35cm x35cm 3mm/1mm to cover entire prostate and seminal
vesicles. Need ADC maps.
Post gadolinium:
Axial post gad: rapid dynamic contrast enhanced Slice thickness 4.0/0.0, sequential 16 axial slices, 20 phase acquisition FOV 22
FOV: Slice Matrix:
Gap Phase Scan
% (mm)
Ax T1 650 10 300 100 5 1 320 256 R->L 1 S->I
Ax T2 3100 91 200 100 3 0 320 320 R->L 3 S->I
Sag T2 3100 91 200 100 3 0 320 320 H->F 3 R->L
Cor T2 3100 91 220 100 3 0 320 320 R->L 3 P->A
99 b values 100,
DWI 8500 300 100 3 0 192 144 A->P 6 S->I 500, and 800
Dynamic Ax 1.86
4.72 260 260 3 1 192 192 a->P 1 S->I
Post
29
APPENDICITIS PREGNANT
(R/O APPENDICITIS)
Coronal T2 SSFSE
Axial T2 SSFSE
Sagittal T2 SSFSE
Coronal T2 FS BH
Axial T2 FS BH
Coronal CISS
Axial CISS (Optional if questioning a kidney stone)
FOV: Slice Matrix:

Gap Phase Scan
% (mm)
COR T2 SSFSE 1600 132 440 100 3 0.3 320 320 R/L 1 P->A
AX T2 SSFSE 1600 132 380 75 3 0.3 320 194 A/P 1 S->I
SAG T2 SSFSE 1600 132 440 100 6 1 320 194 A/P 1 L->R
COR T2 FS BH 1600 132 380 194 3 0.3 320 320 R/L 1 P->A
AX T2 FS 1600 135 380 75 3 0.3 320 194 A/P 1 S->I

COR CISS 191 1.18 400 100 8 2 224 169 R/L 1 P->A
AX CISS 191 1.18 400 100 8 2 224 169 A/P 1 S->I
30
Defecography
Axial T2
Sagittal T2 to obtain midline
Ax T2 Small FOV
COR T2 Small FOV
Sagittal CISS at Rest
Sagittal CISS with Kegel
Sagittal CISS with moderate straining
Sagittal CISS with defecation x 3 attempts
FOV: Slice Matrix: Phase Scan

Gap
Sequence TR TE Frequenc Phas Thicknes Phas Frequenc Directio NEX Directio OTHER
(mm)
y e% s (mm) e y n n
160
AX T2 95 380 75 5 1 320 194 A->P 3 S->I
0
310
Ax T2 SM FOV 91 200 100 3 0 320 256 R->L 3 S->I
0
310
Cor T2 SM FOV 91 220 100 3 0 320 256 R->L 3 P->A
0
140
SAG T2 91 360 100 5 1 320 320 A->P 2 R->L
0
1 slice at
SAG CISS (X4) 3.89 1.7 306 100 5 1 320 256 A->P 1 R->L
midline
31
Rectal Cancer (New Protocol – 3T Preferred)
Should be performed on 3T. Must be done during the day to be monitored by a radiologist.
Planes for Small FOV axial/coronal image angles determined by radiologist
Axial T2 (large FOV)

Sagittal FRFSE T2
Axial Oblique FRFSE T2 (short axis) – These are axial to the long axis of the tumor/rectum
Axial Oblique DWI (B=100, 500, 800)
Coronal Oblique T2 (long axis) – *OPTIONAL* These are parallel to the long axis of the rectum/tumor/anal canal as prescribed
by the radiologist who QC’s the case
Add if tumor is low lying (inferior aspect 5cm or less from anal verge)
Axial Oblique VIBE FS Pre (small FOV: 3mm slice)
Axial Oblique VIBE FS Post (small FOV: 3mm slice)
Coronal Oblique VIBE FS Post (small FOV: 3mm slice)
Sagittal Oblique VIBE FS Post (small FOV: 3mm slice)
32
Tips for MRI technologist:
Call MD to help select the best imaging planes.
Axial Oblique imaging plane must be perpendicular to the long axis of the rectum at the level of the tumor.
High resolution axial oblique images may be repeated if anatomy is curved or the original acquisition does not cover correct anatomy.
If motion artifacts: try fat saturation band or swap phase and frequency.
Rectal Cancer Continued

FOV: Slice Matrix:
Gap Phase Scan
% (mm)
Through the
Axial T2 2500 80 300 100 5 1 448 336 A->P 3 S->I bifurcation
SAG T2 2800 101 250 100 4 1 256 512 S/I 3 R->L
0 GE: Zip512
Axial Obl T2 1.5T: 160 1.5T: 256 1.5T: 256
6100 88 100 3 GE 1.5T: A/P 3 S->I Siemens:
(short axis) 3T: 200 0.3 3T: 320 3T: 320 Interpolation
Ax DWI Min b values 100,
5000 280 100 6 1 128 256 A->P 6 S->I
Skyras: Resolve DWI 500, and 800
0 GE: Zip512
COR OBL T2 1.5T: 160
3000 78 100 3 GE 1.5T: 320 320 R/L 4 A->P Siemens:
(optional) 3T: 200 0.3 Interpolation
AX OBL VIBE FS PRE 6.47 2.65 240 100 3 1 320 240 A/P 4 S->I
AX OBL VIBE FS POST 6.47 2.65 240 100 3 1 320 240 A/P 4 S->I
COR OBL VIBE FS
6.2 2.64 240 100 3 1 320 240 R/L 4 A->P
POST
SAG OBL VIBE FS
6.2 2.64 240 100 3 1 320 240 A/P 4 R->L
POST
33
General Chest (Basic)
Use for mediastinal mass/lymphadenopathy/thymus, etc.
All sequences should be done with breath holding:
Coronal T2
Axial T2
Axial T2 FS
Axial IN/OUT PHASE
Axial 3D VIBE FS (4mm slices)
(0SEC/30 SEC/60 SEC/120 SEC)
Inject and scan at the same time for 0 Sec
- Reformat into axial and coronal
- Subtractions axial and coronal
FOV: Slice Matrix:

Gap Phase Scan
Frequency (mm)
%
COR T2 1820 91 360 100 5 1 320 320 R/L 1 P->A
AXIAL T2 1600 97 360 100 7 1 259 320 A/P 1 S->I
AXIAL T2 FS 1600 97 360 100 7 1 259 320 A/P 1 S->I
1.2/2.4 (3T)
AXIAL IN/OUT
170 2.2/4.4(1.5T) 360 100 7 1 256 256 A/P 1 S->I
PHASE
AXIAL VIBE FS
4.3 1.92 360 100 4 0.6 234 320 A/P 1 S->I
POST
34
Image sources:
http://www3.gehealthcare.com/en/products/categories/magnetic_resonance_imaging/1-5t/optima_mr450w_1-
5t_with_gem_suite#tabs/tab474A2BF180D84862A2F3061065A44677
http://femonum.telecom-paristech.fr/projects.html
https://en.wikipedia.org/wiki/Female_reproductive_system
https://schwannomacasestudy.wordpress.com/
http://radiologykey.com/mri-of-the-abdomen-and-pelvis/
https://mrimaster.com/PLAN%20PROSTATE%20sag%20t2.html
http://clinical.netforum.healthcare.philips.com/us_en/Operate/ExamCards/MRI/15T-Hi-res-MRA-of-aorta-using-navigator-
for-MotionTrak-Japan
http://radiologykey.com/the-kidneys-and-upper-urinary-tract/
35

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BODY MRI PROTOCOLS

FOV MATRIX PHASE SCAN

FOV MATRIX PHASE SCAN

FOV MATRIX PHASE SCAN

Coverage for Multi Echo Apnee Body 20°

FOV MATRIX PHASE SCAN

THICK SLAB ANGLES

FOV: Slice Matrix:

FOV: Slice Matrix:

FOV: Slice Matrix:

AXIAL T2 FS 1600 95 380 75 5 1 194 320 A/P 1 S->I

FOV: Slice Matrix:

FOV: Slice Matrix:

COR T2 FS 1600 91 440 100 5 1 320 320 R/L 1 P->A

AXIAL T1 FS 572 20 380 75 5 1 256 192 A/P 2 S->I

FOV MATRIX PHASE SCAN

FOV: Slice Matrix:

COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A

AX T2 FS 1600 95 380 75 5 1 194 320 A/P 1 S->I

COR VIBE FS 5 MIN

3D PC 38.3 5.6 320 90 .90 1 192 256 R/L 1 S->I

FOV: Slice Matrix:

COR T2 1600 91 440 100 5 1 320 320 R/L 1 P->A

AX T2 FS 1600 95 380 75 5 1 320 194 A/P 1 S->I

COR VIBE 5 MIN

Axial DIR (PERIPHERAL GATED)

Angle for sagittal oblique (candy cane)

FOV: Slice Matrix:

2D TOF – reformat into 3D image

FOV: Slice Matrix:

AX T1 455 20 300 100 5 1 320 256 R->L 1 S->I Whole Pelvis

AX T2 5370 91 200 100 5 1 320 272 R->L 2 S->I

AX T2 FS 3000 91 200 100 5 1 320 272 R->L 2 S->I

SAG T2 5160 91 220 100 5 1 320 272 A->P 3 R->L

FOV Slice Matrix:

AX T2 FS 3450 96 300 100 5 1 320 310 A->P 2 S->I Whole

SAG T2 4960 220 100 4 1 320 256 A->P 3 R->L

LAX to the cervix

FOV: Slice Matrix:

AX T1 4.3 1.89 380 81 3 190 320 A/P 1 S->I ABD/PEL

SAX T2 4900 91 200 100 5 1 272 320 R/L 2 S->I

LAX to the uterus

FOV: Slice Matrix:

FOV: Slice Matrix:

COR T2 FS 3000 86 220 100 3 1 224 320 R/L 4 P->A

FOV: Slice Matrix:

Axial T1 whole pelvis

FOV: Slice Matrix:

FOV: Slice Matrix:

AX T2 FS 1600 135 380 75 3 0.3 320 194 A/P 1 S->I

FOV: Slice Matrix: Phase Scan

Axial T2 (large FOV)

Call MD to help select the best imaging planes.

Rectal Cancer Continued

FOV: Slice Matrix:

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