11/5/2019 MRI knee protocols and planning | indications for MRI knee scan

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SAFETY

BRAIN

MRA BRAIN

MRV BRAIN
Indications for knee MRI scan
> Meniscal disorders: nondisplaced and displaced tears, discoid menisci, menisca
cysts
PAEDIATRIC BRAIN
> Marrow abnormalities: avascular necrosis, marrow edema syndromes, and stres
fractures
ORBITS
Radiology training and Cpd/cme - Hands-on
workshop
IAMS
Ad Cardiac CT level 1 and 2, Frcr preparation,
Ad Musculoskeletal Mri,
DWI IAM
radiologycourses.org
S(CHOLESTEATOMA)
Learn more
MALIGNANT OTITIS

EXTERNA
> Congenital and developmental conditions: blount disease, dysplasia, normal variants
PARANASAL SINUSES
> Synovial based disorders: symptomatic plicae, synovitis ,bursitis, and poplitea
cysts
SELLA(PIT.FOSSA) > Muscle and tendon disorders: strains, partial and complete tears, tendonitis
tendonopathy.
> Mechanical knee symptoms: catching, locking, snapping, crepitus
EPILEPSY PROTOCOL > Vascular conditions: entrapment, aneurysm, stenosis, occlusion
> Neoplasms of bone, joint or soft tissue
TMJS > Infections of bone, joint or soft tissue
> Ligament tears: cruciate, collateral, retinacular
> Osteochondral and articular cartilage infractions
TRIGEMINAL > Osteochondral fractures
> Osteochondritis
> Degenerative chondrosis
FACE
> Chondromalacia
> Acute trauma
SOFT TISSUE NECK > Fractures

Please check our new video tutorial for protocols and

MR SIALOGRAPHY planning
CERVICAL SPINE

MRA NECK

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BRACHIAL PLEXUS Knee MRI scan protocols, positioning and planning

MRA SUBCLAVIANS

CHEST

STERNUM

CLAVICLE

THORACIC SPINE Contraindications

>  Any electrically, magnetically or mechanically activated implant (e.g. cardiac
CARDIAC MRI pacemaker, insulin pump biostimulator, neurostimulator, cochlear implant, and
>  hearing aids)
CARDIAC STRESS PERFUSION >  Intracranial aneurysm clips (unless made of titanium)
>  Pregnancy (risk vs benefit ratio to be assessed)
>  Ferromagnetic surgical clips or staples
MRI KIDNEYS >  Metallic foreign body in the eye
Metal shrapnel or bullet
MRI RENALS
Patient preparation
ADRENALS >  A satisfactory written consent form must be taken from the patient before
entering the scanner room
>  Ask the patient to remove all metal objects including keys, coins, wallet, cards
LIVER with magnetic strips, jewellery, hearing aid and hairpins
>  If possible provide a chaperone for claustrophobic patients (e.g. relative or
>  staff )
MRCP
>  Offer earplugs or headphones, possibly with music for extra comfort
>  Explain the procedure to the patient
PANCREAS >  Instruct the patient to keep still
Note the weight of the patient
SECRETIN STIMULATED MRCP

Mehr Infos!
SMALL

BOWEL(ENTEROCLYSIS)

MRA & MRV Positioning

ABDOMEN >  Feet first supine
BREAST >  Position the knee in the knee coil and immobilise with cushions
>  Give cushions under the ankle for extra comfort
>  Centre the laser beam localiser over the lower border of patella
BREAST IMPLANTS

RECTAL CA PELVIS

PELVIS URINARY BLADDER

FEMALE URETHRA

PROSTATE PELVIS

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SOFT TSSUE PENIS

MRI TESTIS

GYNE PELVIS

PLACENTA MRI

RECTOVAGINAL FISTULA

FISTULA PELVIS

DEFECATING PROCTOGRAM

Suggested protocols, parameters and planning

HIPS
localiser
ARTHROGRAPHY HIPS A three plane localiser must be taken in the beginning to localise and plan th
sequences. Localisers are usually less than 25sec. T1 weighted low resolution scans.
PSOAS

LUMBAR SPINE

SI JOINTS

LUMBOSACRAL PLEXUS

KUB

MR UROGRAPHY PD fat sat axial 3mm

Plan the axial slices on the coronal plane; angle the position block parallel to th
THIGHS medial and lateral condyle of the femur. Check the positioning block in the othe
two planes. An appropriate angle must be given in sagittal plane (perpendicular t
KNEE
the line of femur and tibia). Slices must be sufficient to cover the knee joint from
the tibial tuberosity up to the line of superior border of patella. Phase direction i
the axial scans must be right to left, this is to avoid the artifacts form poplitea
LOWER LEG artery pulsation. Using saturation bands above and below the axial block will reduc
further arterial pulsation artefacts.
ANKLE

FOOT

MRA LEGS

SHOULDER

SCAPULA

ARTHROGRAPHY SHOULDER Parameters

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TR TE SLICE FLIP PHASE MATRIX FOV GAP NEX(AVRAGE)

HUMERUS
3000- 15- 3 MM 130- R>L 256X256 150- 10% 2
4000 20 150 160
ELBOW
PD fat sat coronal 3mm
FOREARM Plan the coronal slices on the axial plane; angle the position block parallel to th
medial and lateral condyle of the femur. Check the positioning block in the othe
WRIST two planes. An appropriate angle must be given in sagittal plane (parallel to the mid
line line of femur and tibia). Slices must be sufficient to cover the knee joint from
the pattela down to the line of popliteal artery. Phase direction in the axial scan
HAND must be head to feet, this is to avoid the artifacts form popliteal artery pulsation
Using saturation bands above and below the coronal block will reduce furthe
MRA UPPER ARM arterial pulsation artefacts.

MRA HAND

SPINAL CORD PROTOCOL

MULTIPLE SCLEROSIS

PROTOCOL

MRA WHOLE BODY

Parameters

TR TE SLICE FLIP PHASE MATRIX FOV GAP NEX(AVERAGE)

3000- 15- 3 MM 130- R>L 256X256 160- 10% 2

4000 20 150 170

T1 tse sagittal
Plan the sagittal slices on the axial plane; angle the position block parallel to the
lateral condyle of the femur(parallel to anterior cruciate ligament). Check the
positioning block in the other two planes. An appropriate angle must be given i
coronal plane (parallel to the mid line of femur and tibia). Slices must be sufficien
to cover the knee joint from the lateral condyle up to medial condyle. Phas
direction in the axial scans must be head to feet, this is to avoid the artifact
form popliteal artery pulsation. Using saturation bands above and below the sagitta
block will reduce further arterial pulsation artefacts.

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Parameters

TR TE SLICE FLIP PHASE MATRIX FOV GAP NEX(AVERAGE)

400- 15- 3 MM 130 H>F 320X256 160- 10% 2

600 25 170

T2 STIR sagittal
Plan the sagittal slices on the axial plane; angle the position block parallel to the
lateral condyle of the femur(parallel to anterior cruciate ligament). Check the
positioning block in the other two planes. An appropriate angle must be given i
coronal plane (parallel to the mid line of femur and tibia). Slices must be sufficien
to cover the knee joint from the lateral condyle up to medial condyle. Phas
direction in the axial scans must be head to feet, this is to avoid the artifact
form popliteal artery pulsation. Using saturation bands above and below the sagitta
block will reduce further arterial pulsation artefacts.

Parameters

TR TE FLIP NEX SLICE MATRIX FOV PHASE GAP TI

4000- 110 130 2 3MM 256X256 160- H>F 10% 130

5000 170

T2*(MEDIC) sagittal
Plan the sagittal slices on the axial plane; angle the position block parallel to the
lateral condyle of the femur(parallel to ACL). Check the positioning block in the
other two planes. An appropriate angle must be given in coronal plane (parallel t
the mid line of femur and tibia). Slices must be sufficient to cover the knee join
from the lateral condyle up to medial condyle. Phase direction in the axial scan
must be head to feet, this is to avoid the artifacts form popliteal artery pulsation
Using saturation bands above and below the sagittal block will reduce furthe
arterial pulsation artefacts.
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Parameters

TR TE FLIP NEX SLICE MATRIX FOV PHASE GAP oversample

800- 15- 30 2 3 MM 256X256 160- H>F 10% 50%

1200 25 170

PD fat sat coronal oblique 2mm for Anterior cruciate

ligament
Plan the coronal oblique slices on the sagittal plane, angle the position block paralle
to the anterior cruciate ligament (ACL). Check the positioning block in the other tw
planes. An appropriate angle must be given in coronal plane parallel to the media
and lateral condyle of the femur. Slices must be sufficient to cover the ACL. The
phase direction for these coronal oblique scans should be right to left to avoid
pulsation artefacts from the popliteal artery. Applying saturation bands above and
below the coronal block will further reduce arterial pulsation artefacts.

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Parameters

TR TE SLICE FLIP PHASE MATRIX FOV GAP NEX(AVERAGE)

3000- 15- 2 MM 130- R>L 256X256 140- 10% 4

4000 20 150 150

PD fat sat sagittal oblique 2mm for ACL

Plan the sagittal oblique slices on the axial plane, angle the position block parallel t
the ACL. Check the positioning block in the other two planes. An appropriate angl
must be given in the coronal plane parallel to the ACL. Slices must be sufficient t
cover the ACL. Phase direction in these sagittal oblique scans should be right t
left to avoid pulsation artefacts from the popliteal artery. Applying saturatio
bands above and below the coronal block will further reduce arterial pulsatio
artefacts.

The phase direction shown in the example below is anterior to posterior. This i
used in departments that utilise radial K-space filling sequences (blade or propeller
for motion correction in knee imaging.

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Parameters

TR TE SLICE FLIP PHASE MATRIX FOV GAP NEX(AVERAGE)

3000- 15- 2 MM 130- H>F 256X256 140- 10% 4

4000 20 150 150

CLICK THE SEQUENCES BELOW TO CHECK THE SCANS

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