MR Urography Protocol

 

Patient Preparation

1. NPO (furosemide)2 hour prior to arriving.

2. Lasix 5 mg. IV at beginning of exam. If necessary, patient may obtain prescription from referring physician and bring Lasix with them to exam. Give Lasix after Series 5 below. If Lasix is not available, administer 250 ml saline immediately prior to exam.

3. Prone position preferred.

4.Phase array body coil (2 coils for Espree), centered on umbilicus

Pulse Sequences

If Lasix is not available, administer 250 ml IV saline immediately prior to exam.

1. Survey as per standard abdomen protocol

2. Ref scan

3. Coronal single shot TEef ~200ms, FOV=40 6mm thick, 5mm increments (1 mm overlap)

4. Axial single shot TEef~200 (like in liver, but through entire sensitive range of coil) 6mm thick, 5mm increments (1 mm overlap)

5. Axial dual gradient echo

GIVE LASIX

6. Radial MRCP, centered below each kidney. Either breathhold with 10 sec between each slice, or respiratory triggered.

7. Coronal MRCP of both ureters, repeated 8 times with at least 10 seconds between each ("cine")

8. Axial dynamic fatsat 3D (THRIVE, VIBE, LAVA) including entire kidneys and below. Pre plus 3X post

(Gad dose = 0.05 mmol/kg MultiHance)

9. Axial fatsat 3D of pelvis

10. Coronal fatsat 3D of entire kidneys/ureters/bladder, first with flip=15 and then with flip=40. For Espree, obtain two sets, using upper and lower coils respectively.