MR Enterography Protocol

Information for Scheduling the Exam

1.     Fasting beginning 2 hours prior to arriving. However, the patient can take all medications as usual with small sips of water.

2.     Patient should arrive 2 hours prior to their appointment time for registration and for the administration of oral contrast.

3.     Oral contrast is Volumen beginning 1 hour before scanning. Drink 1 bottle (450 ml each) every 20 minutes for a total of 3 bottles (i.e. a total of 1350 ml).

4.     If the patient has outside prior exams and reports, the patient should bring them to their MRI appointment for comparison review.

5.     There are no post instructions after the MRI study. The patient can eat and drink accordingly.

Information for MRI Technologists

Background

  1. Surface Coil
    1. Philips Achieva- SENSE Body coil, centered on umbilicus.
    2. GE Optima 450W- Torso Coil
    3. Siemens Espree- Use 2 contiguous anterior coils (upper & lower abdomen).

                                                    i.     NOTE: For the Siemens Espree, separate series of the upper and lower abdomen need to be performed so that the upper and lower abdomen, respectively, are isocenter.

  1. Prone position is preferred. Note that images should be corrected and sent to iSite PACS oriented supine.
  2. To avoid wraparound artifact, the patient’s arms should be place superior to the surface coil, preferably above the head. If the patient cannot tolerate this, the arms should be placed as close to the body as possible.

Pulse Sequences- Philips Achieva

  1. BFFE survey (6 mm slice thickness at 6 mm increments)
  1. Coronal SS-TSE (TE~200) (6 mm slice thickness at 5 mm increments)
  1. Axial SS-TSE (TE~200) (6 mm slice thickness at 5 mm increments)
  2. Coronal Dual GRE
  3. Coronal THRIVE (Pre contrast)

·       Bolustrak

    1. IV Contrast- 0.1 mmol/kg Multihance
  1. Coronal THRIVE (dynamic arterial & venous)
  2. Axial SS-TSE SPAIR (TE~80) (6 mm slice thickness at 5 mm increments)
  3. Coronal SS-TSE SPAIR (TE~80) (6 mm slice thickness at 5 mm increments)
  4. Coronal THRIVE (delayed)
  5. Axial THRIVE (delayed) (upper, lower)
  6. Diffusion weighted images (b = 0, 20, and 800). Please also send ADC map to PACS.
  7. Coronal CINE BFFE of abdomen and pelvis. Try to cover the entire small bowel, especially the terminal ileum.
    1. 10 contiguous 8 mm slices with a gap of 1.5 mm.
    2. Obtain 1 phase per image obtained sequentially for a total of 25 phases per image

Pulse Sequences- GE Optima 450W

  1. SSFSE 3-plane survey (8 mm slice thickness at 8 mm increments)
  2. Coronal SS-TSE (TE~200) (5 mm slice thickness at 5 mm increments)
  3. Axial SS-TSE (TE~200) (5 mm slice thickness at 5 mm increments)
  4. Coronal LAVA-flex (Pre contrast)

·       Bolustrak

    1. IV Contrast- 0.1 mmol/kg Multihance
  1. Coronal LAVA-flex (dynamic arterial & venous)
  2. Axial SS-TSE with fatsat (TE~80) (5 mm slice thickness at 5 mm increments)
  3. Coronal SS-TSE (TE~80) with fatsat (TE~80) (5 mm slice thickness at 5 mm increments)
  4. Coronal LAVA-flex (delayed)
  5. Axial LAVA-flex (delayed) (upper, lower)
  6. Diffusion weighted images (b = 0, 20, and 800). Please also send ADC map to PACS.
  7. Coronal CINE FIESTA of abdomen and pelvis. Try to cover the entire small bowel, especially the terminal ileum.
    1. 10 contiguous 8 mm slices with a gap of 1.5 mm.
    2. Obtain 1 phase per image obtained sequentially for a total of 25 phases per image

Pulse Sequences- Siemens Espree

  1. TRUEFISP scout
  2. Coronal SS-TSE (T2 HASTE) (TE~200) (5 mm slice thickness at 5 mm increments)
  3. Axial SS -TSE (T2 HASTE) (TE~200) (5 mm slice thickness at 5 mm increments)
  4. Coronal Dual GRE
  5. Coronal VIBE (Pre contrast)

·       Care Bolus

    1. IV Contrast- 0.1 mmol/kg Multihance
  1. Coronal VIBE (dynamic arterial & venous)
  2. Coronal SPAIR SS-TSE (TE~80) (5 mm slice thickness at 5 mm increments)
  3. Axial SPAIR SS-TSE (TE~80) (5 mm slice thickness at 5 mm increments)
  4. Coronal VIBE (delayed)
  5. Axial VIBE (delayed) 2 sets (upper & lower abdomen)
  6. Diffusion weighted images (b = 0, 20, and 800). Please also send ADC map to PACS.
  7. Coronal CINE TRUEFISP of abdomen and pelvis. Try to cover the entire small bowel, especially the terminal ileum. Obtain one series of the abdomen and one series of the pelvis, making sure there is overlap.
    1. 10 contiguous 8 mm slices with a gap of 1.5 mm.
    2. Obtain 1 phase per image obtained sequentially for a total of 25 phases per image

Documentation for the “MEMO” section on iSite

  1. In the memo section on iSite, please list the following…
    1. Dose of IV Multihance (i.e. 14 ml of Multihance given IV via left antecubital fossa)
    2. The amount and timing of Volumen (i.e. A total of 1350 ml of Volumen given over 1 hour beginning at 12:30 pm)

 

 

Rev: September 10, 2015