mrimaster

Pituitary Dynamic MRI

Common Indications for dynamic pituitary mri

Contraindications

Patient preparation for dynamic pituitary mri

Positioning for dynamic pituitary mri

mri brain planning and positioning

Recommended dynamic pituitary mri Protocols and Planning

Pituitary MRI localiser

A three-plane localizer must be taken at the beginning to localize and plan the sequences. Localizers are usually less than 25 seconds and are T1-weighted low-resolution scans.

T2 tse axial 4mm

Plan the axial slices on the sagittal plane and position the block parallel to the genu and splenium of the corpus callosum. Verify the planning block in the other two planes and ensure that an appropriate angle is maintained in the coronal plane, making it perpendicular to the line of the midline of the brain and the 4th ventricle. Ensure that the number of slices is sufficient to cover the entire brain from the vertex to the line of the foramen magnum.

mri brain protocol and planning of axial scans

Parameters

TR

4000-5000

TE

100-120

SLICE

4MM

FLIP

130-150

PHASE

R>L

MATRIX

320X320

FOV

210-230

GAP

10%

NEX(AVRAGE)

2

T1 tse DIXON 2mm sagittal SFOV pre contrast

Plan the sagittal slices on the axial plane, and angle the planning block parallel to the midline of the brain. Verify the planning block in the other two planes. Ensure an appropriate angle is given in the coronal plane, parallel to the midline of the brain. Slices should be sufficient to cover the entire pituitary gland from the right to left internal carotid arteries.

pituitary fossa mri sagittal planing

Parameters

TR

400-500

TE

15

FAT SAT

DIXON

NEX

4

SLICE

2MM

MATRIX

256×256

FOV

100-120

PHASE

A>P

OVERSAMPLE

100%

GAP

10%

T2 tse coronal 2mm

Plan the coronal slices on the sagittal plane. Angle the planning block perpendicular to the Sella turcica. Check the planning block in the other two planes. An appropriate angle must be given in the axial plane (perpendicular to the midline of the brain). Slices must be sufficient to cover the whole pituitary gland from the anterior border of the sphenoid sinus to the line of the anterior border of the pons.

pituitary fossa mri coronal planing

Parameters

TR

4000-5000

TE

110

FLIP

150

NEX

4

SLICE

2MM

MATRIX

256×256

FOV

100-120

PHASE

R>L

OVERSAMPLE

100%

GAP

10%

T1 tse DIXON 2mm coronal pre contrast

Plan the coronal slices on the sagittal plane. Angle the planning block perpendicular to the Sella turcica. Check the planning block in the other two planes. An appropriate angle must be given in the axial plane (perpendicular to the midline of the brain). Slices must be sufficient to cover the whole pituitary gland from the anterior border of the sphenoid sinus to the line of the anterior border of the pons.

pituitary fossa mri coronal planing

Parameters

TR

400-500

TE

15

FAT SAT

DIXON

NEX

4

SLICE

2MM

MATRIX

256×256

FOV

100-120

PHASE

A>P

OVERSAMPLE

100%

GAP

10%

contrast administration and timing of scans

Conducting a dynamic pituitary study with the Guess timing technique:

A dynamic pituitary examination uses one of the simplest contrast monitoring timing methods called the Guess timing technique. It works by estimating the time it takes for contrast to travel from the injection site to the vascular structures of the pituitary gland. This technique is highly dependent on factors such as the site of contrast injection, the patient’s age, cardiac output, and vascular anatomy. Generally, it takes about 4-5 seconds for the contrast to travel from the antecubital vein to the heart and 5-6 seconds to reach the pituitary gland. Therefore, the first acquisition of the dynamic sequence should begin within 8-10 seconds of contrast administration.

Establishing Protocols for Dynamic Pituitary Study

The dynamic pituitary imaging protocol employs a dynamic sequence based on T1 TSE, comprising one pre-contrast acquisition followed by three post-contrast acquisitions. Between the initial and second measurement, there is an 8-second interval. Users should initiate the contrast injection immediately after completing the first measurement. The second measurement will commence automatically after 8 seconds of contrast administration. Typically, the scan protocol is configured with 5 slices, each 3mm thick, utilizing low resolution and a small field of view (FOV). The maximum acquisition time for each measurement should not exceed approximately 25 seconds.

T1 TSE dynamic with 1 pre-contrast 3 post-contrast measurements

Plan the coronal slices on the sagittal plane. Angle the planning block perpendicular to the Sella turcica. Check the planning block in the other two planes. An appropriate angle must be given in the axial plane (perpendicular to the midline of the brain). Slices must be sufficient to cover the whole pituitary gland from the anterior border of the sphenoid sinus to the line of the anterior border of the pons.

pituitary fossa mri protocol and planning of coronal dynamic scans

Parameters

TR

280-350

TE

15

FAT SAT

OFF

NEX

1

SLICE

3MM

MATRIX

192×192

FOV

130-160

PHASE

R>L

DYNAMIC

4 mesurments 

OS

50%

T1 tse DIXON 2mm sagittal SFOV post contrast

Plan the sagittal slices on the axial plane, and angle the planning block parallel to the midline of the brain. Verify the planning block in the other two planes. Ensure an appropriate angle is given in the coronal plane, parallel to the midline of the brain. Slices should be sufficient to cover the entire pituitary gland from the right to left internal carotid arteries.

pituitary fossa mri sagittal planing

Parameters

TR

400-500

TE

15

FAT SAT

DIXON

NEX

4

SLICE

2MM

MATRIX

256×256

FOV

100-120

PHASE

A>P

OVERSAMPLE

100%

GAP

10%

T1 tse DIXON 2mm coronal post contrast

Plan the coronal slices on the sagittal plane. Angle the planning block perpendicular to the Sella turcica. Check the planning block in the other two planes. An appropriate angle must be given in the axial plane (perpendicular to the midline of the brain). Slices must be sufficient to cover the whole pituitary gland from the anterior border of the sphenoid sinus to the line of the anterior border of the pons.

pituitary fossa mri coronal planing

Parameters

TR

400-500

TE

15

FAT SAT

DIXON

NEX

4

SLICE

2MM

MATRIX

256×256

FOV

100-120

PHASE

A>P

OVERSAMPLE

100%

GAP

10%