Hitachi - Low Field Protocol - Body - Neck - Soft

tissue
-AX FSE T2

-AX T1

-AX STIR

-COR FSE

POST CONTRAST

-COR T1

-AX T1

-3D COR SARG GE RSSG T1 3 X 3 THICKNESS (NOT IN PROTOCOL) RECON IN AXIAL PLAIN

Hitachi - Low Field Protocol - MSK - Ankle -

Achilles
SCAN WITH FOOT DORSI FLEXED

-SAG T1 LOC (GET 7-8 SLICES THROUGH ACHILLES)

-AX T1

-AX T2

-AX STIR

-SAGT2

-SAG STIR

-COR FSE T2

IF 3D IS ORDERED, DROP AX FSE T2 AND SCAN 3D SAG T2 (SG) 1.5 / 1.5 REFORMAT IN
BOTH AX AND COR PLANE 3/3

Hitachi - Low Field Protocol - MSK - Ankle -

Achilles / Posterior Tibial Tendon (PTT) combo
STARTING WITH THE ACHILLES SCAN WITH FOOT DORSI FLEX
-SAG T1 LOC 7-8 SLICES THROUGH ACHILLES

-COR FSE T2

-SAG FSE

-SAG STIR

-AX STIR

-IF 3D IS ORDERED DROP THE AX STIR ON THE ACHILLES AND SCAN 3D SAG T2 (SG)
1.5X1.5 THRU ACHILLES, SET UP ON AX OR COR LOC WITH REFORMATS IN AX AND COR
PLANES 3/3.

-RE-LOC PLANTAR FLEX FOR TENDONS

-AX T1

-AX STIR (if you have a .7 Altaire do proton dense/fat sat instead of stir only on the plantar flex)

-COR FSE (optional #1) CAN DROP FIRST UNLESS complex case or you see talar dome pathology,
but only if running behind or pt can’t tolerate 

-AX FSE optional #2 CAN DROP SECONDLY ONLY IF RUNNING BEHIND OR PT CAN’T
TOLERATE 

IF TIME PERMITS DO ALL

**NOTE TO TECHS - GET 3D ADDED TO SCRIP FOR THESE DIAGNOSES PER

RADIOLOGIST RECOMMENDATIONS TO BETTER VISUALIZE PATHOLOGY. MUST DO
3D FOR SESAMOID EVEN WITHOUT SCRIP.

Hitachi - Low Field Protocol - MSK - Ankle - All

-AX T1

-AX FSE T2

-AX STIR

-SAG STIR

-COR FSE T2

-COR 3D T2 SG 1.5-1.7 (PERONEUS OR PERONEAL TENDONS, OR IF ORDERED)

1.5/1.5 SET UP ON SAG AND ANGLE WITH TENDONS, INCLUDE AS MUCH OF THE ANKLE JT
AS POSSIBLE. REFORMAT IN BOTH AX AND SAG PLANES 3/3.

-PLANTAR FLEX FOOT OR SCAN PRONE FOR ALL ANKLES, EXCEPT FOR ACHILLES AND
OCD - SEE SEPARATE PROTOCOLS FOR ACHILLES AND OCD
Hitachi - Low Field Protocol - MSK - Ankle -
Osteochondritis Dissecans (OCD) / Talar Dome
SCAN WITH FOOT IN NEUTRAL POSITION

IF DIAGNOSIS ALSO INCLUDES CONCERNS FOR TENDON TEAR (EXCEPT ACHILLES),

DO STANDARD ANKLE PROTOCOL PLANTAR FLEXED

COR STIR (if you have an Altair do a proton dense / FatSat instead of stir)

AX T1

AX T2 

SAG STIR

COR T1

IF 3D IS ORDERED, DO 3D COR T2 (SG) 1.5/1.5 REFORMAT IN AX AND SAG PLANE 3/3, AS

AN EXTRA SEQUENCE. DO NOT DROP ANYTHING. 

Hitachi - Low Field Protocol - MSK - Elbow

-AX T1

-AX FSE T2

-COR T1

-COR STIR

-SAG FSE T2

-AX STIR FOR TENDON

3D COR SARGE RSSG T1 2 X 2 THICKNESS (NOT IN PROTOCOL) RECON IN AXIAL PLANE

Hitachi - Low Field Protocol - MSK - Femur -

Long bones
-AX T1

-AX T2

-AX STIR

-COR T1
-COR STIR OR T2 FS

-SAG T2

Hitachi - Low Field Protocol - MSK - Foot

-AX T1

-AX FSE T2

-COR FSE

-SAG T1

-SAG STIR

-COR T1 OPT FOR FX

-3D SAG GE SG T2 1.5 X 1.5 THICKNESS THROUGH AREA OF INTEREST. REFORMAT IN AX

AND COR 3/3 (PLEASE TRY TO INCLUDE 3D AS AN ADDITIONAL SEQUENCE FOR ALL
FEET WITH THE FOLLOWING DIAGNOSIS: FX, PLANTAR PLATE TEAR/ RUPTURE,
SESAMOID PATHOLOGY, FOREIGN BODY AND BONE TUMOR.)

Note: PLANTAR PLATE TEAR AND ANY SESAMOID PATHOLOGY SHOULD BE SCANNED

USING TOE PROTOCOL. 

Note: The plantar plate is at the mtp joints, and should not be confused with the plantar fascia

**3D FOR MORTONS NEUROMA SCAN 3D SG COR 1.5 X 1.5 REFORMAT IN SAG / AX
PLANES 3/3

SEE SEPARATE PROTOCOLS FOR OSTEOMYELITIS OF THE TOE OR FOOT

Hitachi - Low Field Protocol - MSK - Foot - Liz

Franc
-AX T1

-AX T2

-COR T1

-SAG STIR

-COR STIR

-COR 3D GE SG T2 1.5 X 1.5 ADD AS EXTRA SEQUENCE IN PROTOCOL RECON IN SAG / AX

PLANE 3/3 CALL FOR SCRIP FROM REFERRING
Hitachi - Low Field Protocol - MSK - Foot -
Osteomyelitis
AX T1 120 FOV SLICE THICKNESS 3/4

AX T2 150 FOV SLICE THICKNESS 4/5

SAG STIR 180 FOV SLICE THICKNESS 4/5

COR STIR 180 FOV SLICE THICKNESS 4/5

COR T1 150 FOV SLICE THICKNESS 3/4

SAG 3D RSSG T1 180FOV SLICE THICK 1.5-1.7

USE THIS PROTOCOL IF AREA OF INTEREST IS TOES, OTHERWISE USE ROUTINE

FOOT PROTOCOL

Hitachi - Low Field Protocol - MSK - Hamstring

- Proximal
-AX FSE T2

-AX STIR

-AX T1

-COR STIR

-SAG FSE T2

-COR FSE T2

-AX 3D T2 TENDON – SG

Hitachi - Low Field Protocol - MSK - Hips

-COR T1 BILATERAL

-AX T1 UNILATERAL

-AX 3D SARG (T1 GE RSSG) 1.5 - 1.7 mm

-COR 3D SARGE (T1 GE RSSG) 1.5 - 1.7 mm

-COR STIR UNILATERAL

-SAG STIR

-SAG T1 optional if time allows

Hitachi - Low Field Protocol - MSK - Humerus -

Long bones
-AX T1

-AX T2

-AX STIR

-COR T1

-COR STIR OR T2FS

-SAG T2

Hitachi - Low Field Protocol - MSK - Knee

-AX T2

-COR STIR

-SAG FSE T2

-COR T1 (OVER 50)

-SAG T1 (UNDER 50)

-SAG 3D SARG (T1 GE RSSG) (RECONSTRUCT IN COR PLANE IF 3-D ORDERED) THICKNESS
SHOULD BE SQUARE 1.7 X 1.7 OR LARGER IF NEEDED. PER PT. SIZE. RECONSTRUCT IN
LARGER SLICE THICKNESS THAN WHAT PT WAS SCANNED IN.

Hitachi - Low Field Protocol - MSK - Sacroiliac

(SI) Joint
-AX T1

-AX FSE T2

-AX STIR ANGLE WITH L5-S1 

-COR T1

-COR STIR PARALLEL TO SACRUM

-SAG FSE T2

Hitachi - Low Field Protocol - MSK - Shoulder

- AX STIR

- COR T2

- COR STIR

- SAG STIR

- COR T1

- COR SG 3D T2

- AX T1

- FOR ALL SHOULDERS INCLUDING LABRAL TEAR!

- If any motion repeats the first 4 sequences, then repeat prior to doing the Cor T1, Cor 3D or the
Ax T1. If short on time omit the Ax T1, then the Cor 3d. Always do the Cor 3D, even it is not
ordered. Also reformat in Cor and Ax plane. 

Hitachi - Low Field Protocol - MSK - Tibia /

Fibula - Long bones
-AX T1

-AX T2

-AX STIR

-COR T1

-COR STIR OR T2 FS

-SAG T2

Hitachi - Low Field Protocol - MSK - Toe

SCAN PRONE IN WRIST OR KNEE COIL FOR OPTIMAL SIGNAL (or if possible supine
plantar flexed)

-AX T1 120 FOV SLICE THICKNESS 3/4   

-AX T2 150 FOV SLICE THICKNESS 4/5  

-COR T2 150FOV SLICE THICKNESS 3/4 4NSA

-SAG T1 150 FOV SLICE THICKNESS 3/4

-SAG STIR 180 FOV SLICE THICKNESS 4/5 

-3D T2 (SG) SAG 150FOV 1.5/1.5 SLICE THICKNESS THROUGH TOE OF INTEREST TRY TO
INCLUDE AT LEAST 3 TOES. REFORMAT IN AX AND COR 3/3 SLICE THICKNESS (PLEASE
TRY TO INCLUDE THIS SEQUENCE AS AN ADDITIONAL SEQUENCE FOR ALL TOES WITH
THE FOLLOWING DIAGNOSIS: FX, PLANTAR PLATE TEAR/ RUPTURE, SESAMOID
PATHOLOGY AND BONE TUMOR, MPJ PATHOLOGY). 

*NOTE TO TECHS- GET 3D ADDED TO SCRIPT FOR THESE DIAGNOSES PER RADIOLOGIST
RECOMMENDATION TO BETTER VISUALIZE PATHOLOGY. MUST DO 3D FOR SESAMOID
EVEN WITHOUT SCRIP.

IF YOU HAVE TO USE THE HEAD COIL FOR THE TOE, USE THE FOOT PROTOCOL NO
ALTERATIONS OR FOV CHANGES.

PLEASE MAKE SURE TO CENTER OVER THE TOE AND TURN OFF ANTI ALIASING WHEN
POSSIBLE - SHOULD NOT WRAP IF PLANTAR FLEXED (A SMALL AMT OF WRAP IS OK IF
NOT IN THE ANATOMY)

Hitachi - Low Field Protocol - MSK - Toe -

Osteomyelitis
AX T1 120 FOV SLICE THICKNESS 3/4

AX T2 150 FOV SLICE THICKNESS 4/5

SAG STIR 180 FOV SLICE THICKNESS 4/5

COR STIR 180 FOV SLICE THICKNESS 4/5

COR T1 150 FOV SLICE THICKNESS 3/4

SAG 3D RSSG T1 180FOV SLICE THICK 1.5-1.7

USE THIS PROTOCOL IF AREA OF INTEREST IS TOES, OTHERWISE USE ROUTINE

FOOT PROTOCOL

Hitachi - Low Field Protocol - MSK - Wrist

-AX T1

-AX T2

-COR T1
-COR STIR

-COR GE T2

-SAG STIR

-COR 3D GE SG T2 2 X 2 THICKNESS (IN PROTOCOL) 

Hitachi - Low Field Protocol - Neuro - Brachial

Plexus
-COR T1

-COR T2

-AX T1

AX FSE T2

AX STIR

SAG T2 AFFECTED SIDE

BILAT COR AND AX IN BODY COIL

Hitachi - Low Field Protocol - Neuro - Brain

-SAG T1

-AX FSE T2

-AX FLAIR 

-AX T1 

-COR FSE T2 FOR SEIZURE, MEMORY LOSS AND DEMENTIA

POST CONTRAST

-AX T1

-COR T1

3D AX GE RSSG T1 3 X 3 THICKNESS (NOT IN PROTOCOL) RECON IN CORONAL PLANE

Hitachi - Low Field Protocol - Neuro - Brain - MS

-SAG T1
-AX FSE T2

-AX FLAIR 

-AX T1 

-SAG FLAIR 

POST CONTRAST

-AX T1

-COR T1

Hitachi - Low Field Protocol - Neuro - Internal

auditory canal (IAC)
-SAG T1

-AX FSE T2

-AX DEQ FIR DE FLAIR 

-AX T1

POST CONTRAST

-AX T1

-COR T1

3D AX T2 FSE DE 1.6 X 1.6 THICKNESS (NOT IN PROTOCOL) RECON COR

Hitachi - Low Field Protocol - Neuro - Sacrum

-COR T1

-COR FSE T2

-COR STIR 

-AX FSE 

-AX T1

Hitachi - Low Field Protocol - Neuro - Sella

-SAG T1
-AX FSE T2

-AX DEQ FIR DE FLAIR

-COR T1

-POST CONTRAST

-COR T1

-SAG T1

Hitachi - Low Field Protocol - Neuro - Spine -

Cervical
-SAG FSE T2

-SAG T1

-AX SHIM

-AX BASG (IF PT IS IN PAIN CAN DROP SHIM AND AX BASG AND DO A GE  AX NORM
600TR)

-AX T1 PRE ONLY

-SAG T1 OBL TO THE AFFECTED SIDE

-SAG STIR IF TRAUMA

Hitachi - Low Field Protocol - Neuro - Spine -

Lumbar
-SAG FSE T2

-SAG T1 

-AX FSE T2

SAG STIR (PRE, UNDER 25, TRAUMA / INJURY SIX MONTHS)

-AX T1 (PRE ONLY)

AX T1 BLOCK (TRAUMA OR UNDER 25)

3D MYELOGRAM, IF ORDERED
Hitachi - Low Field Protocol - Neuro - Spine -
Thoracic
-SAG FSE T2

-SAG T1

-AX FSE T2

-AX T1 PRE ONLY

SAG STIR IF TRAUMA

3D MYELO IF ORDERED

Hitachi - Low Field Protocol - Neuro -

Temporomandibular joint (TMJ)
-AX T1 BILAT

-SAG T2 CLOSED BIL

-SAG T1 CLOSED BIL

-SAG T2 OPENED BIL

-SAG T1 OPENED BIL

Hitachi - Low Field Protocol - TIPS

-3D CAN BE PERFORMED ON ANY BODY PART; THESE ARE THE ONES WE USE THE MOST.

-GE RSSG - T1 WEIGHTED THE HIGHER THE FLIP ANGLE THE MORE T1 PROPERTIES

-GE SG-T2 WEIGHTED

-ALWAYS USE SQUARE ie (1.5 X 1.5) SLICE THICKNESS ON 3DS AND A LAGER SLICE
THICKNESS THEN WHAT YOU SCANNED IN FOR THE RECONSTRUCTIONS.

Hitachi