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Large Pelvic and Abdominal Mass MRI Protocol and Planning

Indications for MRI Large Pelvic and Abdominal Mass scans

Contraindications

Patient preparation for MRI Large Pelvic and Abdominal Mass scans

Positioning for MRI Large Pelvic and Abdominal Mass scans

MRI GYNAECOLOGY PELVIS positioning image

Recommended MRI Large Pelvic and Abdominal Mass scan Protocols and Planning

MRI localiser

A three-plane localiser must be taken at the beginning to localise and plan the sequences. Localisers are normally less than 25 seconds and are T2-weighted low-resolution scans.

MRI LARGE ABDOMEN AND PELVIC MASSES localiser image

Pause for buscopan injection

Before proceeding to the next step, intravenously inject 0.5 to 1 ml of Buscopan (according to the manufacturer’s instructions and departmental policy). Wait for 1 minute before starting the next scan (Buscopan takes a few seconds to start its function).

Warning

* Buscopan injection should not be administered to patients with myasthenia gravis, megacolon, narrow angle glaucoma, tachycardia, prostatic enlargement with urinary retention, mechanical stenoses in the region of the gastrointestinal tract or paralytic ileus.*

T2 tse sagittal large FOV 4mm multiple breath hold / respiratory gated

Plan the sagittal slices on the coronal plane and align the positioning block vertically across the abdomen. Verify the positioning block in the other two planes. In the axial plane, plan the block vertically across the abdomen as shown. Ensure that the slices cover the entire pelvic and abdominal mass, extending from the right to the left. The field of view (FOV) should be sufficiently large to encompass the mass, typically ranging from 350mm to 400mm. Ensure an adequate level of phase oversampling to prevent any wrap-around artifacts.

Due to the large number of slices, the scan is split into three breath-hold acquisitions, each around 20 seconds long. Instruct the patient to hold their breath during the image acquisition. If T2 TSE scans are not available on your scanner, please use TSE-based single-shot sequences (e.g., HASTE). If the patient is unable to hold their breath, consider using respiratory-gated sequences or radial k-space sequences (e.g., BLADE T2)

MRI Large abdomen and Pelvic Masses and protocol and planing of sagittal scans

Parameters

TR

4000-5000

TE

100-120

SLICE

4 MM

FLIP

130-150

PHASE

A>P

MATRIX

320X320

FOV

350-400

GAP

10%

NEX(AVRAGE)

2

T2 tse axial large FOV 5mm multiple breath hold / respiratory gated

Plan the large field of view (FOV) T2 axial slices on the coronal plane, positioning the block parallel to the line along the right and left iliac crest. Verify the positioning block in the other two planes as well. Establish an appropriate angle in the sagittal plane, perpendicular to the lumbar spine. Ensure that the slices cover the entire pelvic and abdominal mass from top to bottom. The field of view (FOV) should be sufficiently large to encompass the mass, typically ranging from 350mm to 400mm. Use right-to-left phase direction with an adequate level of phase oversampling to prevent any wrap-around artifacts.

Due to the large number of slices, the scan is split into four breath-hold acquisitions, each around 20 seconds long. Instruct the patient to hold their breath during the image acquisition. If T2 TSE scans are not available on your scanner, please use TSE-based single-shot sequences (e.g., HASTE). If the patient is unable to hold their breath, consider using respiratory-gated sequences or radial k-space sequences (e.g., BLADE T2). Using saturation bands above and below the planning block can minimize breathing, pulsation, and peristalsis-related artifacts.

MRI Large abdomen and Pelvic Masses and protocol and planing of axial scans

Parameters

TR

4000-5000

TE

100-120

SLICE

5 MM

FLIP

130-150

PHASE

R>L

MATRIX

320X320

FOV

350-400

GAP

10%

NEX(AVRAGE)

2

T1 tse axial large FOV 5mm multiple breath hold / respiratory gated

Plan the large field of view (FOV) T1 axial slices on the coronal plane, positioning the block parallel to the line along the right and left iliac crest. Verify the positioning block in the other two planes as well. Establish an appropriate angle in the sagittal plane, perpendicular to the lumbar spine. Ensure that the slices cover the entire pelvic and abdominal mass from top to bottom. The field of view (FOV) should be sufficiently large to encompass the mass, typically ranging from 350mm to 400mm. Use right-to-left phase direction with an adequate level of phase oversampling to prevent any wrap-around artifacts.

Due to the large number of slices, the scan is split into four breath-hold acquisitions, each around 20 seconds long. Instruct the patient to hold their breath during the image acquisition. If the patient is unable to hold their breath, consider using respiratory-gated sequences or radial k-space sequences (e.g., BLADE T1). Using saturation bands above and below the planning block can minimize breathing, pulsation, and peristalsis-related artifacts.

MRI Large abdomen and Pelvic Masses and protocol and planing of axial scans

Parameters

TR

400-600

TE

15-25

SLICE

5 MM

FLIP

130

PHASE

R>L

MATRIX

320X320

FOV

350-400

GAP

10%

NEX(AVRAGE)

2

T1 tse fat saturated large FOV 5mm free breathing

Plan the large field of view (FOV) T1 fat saturated axial slices on the coronal plane, positioning the block parallel to the line along the right and left iliac crest. Verify the positioning block in the other two planes as well. Establish an appropriate angle in the sagittal plane, perpendicular to the lumbar spine. Ensure that the slices cover the entire pelvic and abdominal mass from top to bottom. The field of view (FOV) should be sufficiently large to encompass the mass, typically ranging from 350mm to 400mm. Use right-to-left phase direction with an adequate level of phase oversampling to prevent any wrap-around artifacts. Instruct the patient to breathe gently during the image acquisition. Using saturation bands above and below the planning block can minimize breathing, pulsation, and peristalsis-related artifacts.

MRI Large abdomen and Pelvic Masses and protocol and planing of axial scans

Parameters

TR

400-600

TE

15-25

SLICE

5 MM

FLIP

130

PHASE

R>L

MATRIX

320X320

FOV

350-400

GAP

10%

NEX(AVRAGE)

2

EPI DWI (b0-b500-b1000)large FOV 5mm free breathing

Plan the large field of view (FOV) EPI DWI axial slices on the coronal plane, positioning the block parallel to the line along the right and left iliac crest. Verify the positioning block in the other two planes as well. Establish an appropriate angle in the sagittal plane, perpendicular to the lumbar spine. Ensure that the slices cover the entire pelvic and abdominal mass from top to bottom. The field of view (FOV) should be sufficiently large to encompass the mass, typically ranging from 350mm to 400mm. Use right-to-left phase direction with an adequate level of phase oversampling to prevent any wrap-around artifacts. Instruct the patient to breathe gently during the image acquisition. Using saturation bands above and below the planning block can minimize breathing, pulsation, and peristalsis-related artifacts.

MRI Large abdomen and Pelvic Masses and protocol and planing of axial scans

Parameters

TR

6000-7000

TE

90

IPAT

ON

NEX

3      5      8

SLICE

5 MM

MATRIX

208X208

FOV

350-400

PHASE

R>L

GAP

10%

B VALUE

0
500
1000

T2 tse coronal large FOV 4mm multiple breath hold / respiratory gated

Plan the coronal T2 TSE slices on the sagittal plane and align the positioning block vertically across the abdomen. Verify the positioning block in the other two planes. In the axial plane, plan the block horizontally across the abdomen, as shown. Ensure that the slices cover the entire pelvic and abdominal mass, extending from the anterior to the posterior. The field of view (FOV) should be sufficiently large to encompass the mass, typically ranging from 350mm to 400mm. Use a right-to-left phase direction with an adequate level of phase oversampling to prevent any wrap-around artifacts.

Due to the large number of slices, the scan is split into three breath-hold acquisitions, each approximately 20 seconds long. Instruct the patient to hold their breath during image acquisition. If T2 TSE scans are unavailable on your scanner, please use TSE-based single-shot sequences (e.g., HASTE). If the patient is unable to hold their breath, consider using respiratory-gated sequences or radial k-space sequences (e.g., BLADE T2).

MRI Large abdomen and Pelvic Masses and protocol and planing of coronal scans

Parameters

TR

4000-5000

TE

100-120

SLICE

4 MM

FLIP

130-150

PHASE

R>L

MATRIX

320X320

FOV

350-400

GAP

10%

NEX(AVRAGE)

2

STIR large FOV 5mm BLADE free breathing / respiratory gated

Plan the coronal T2 TSE slices on the sagittal plane and align the positioning block vertically across the abdomen. Verify the positioning block in the other two planes. In the axial plane, plan the block horizontally across the abdomen, as shown. Ensure that the slices cover the entire pelvic and abdominal mass, extending from the anterior to the posterior. The field of view (FOV) should be sufficiently large to encompass the mass, typically ranging from 350mm to 400mm. Use a right-to-left phase direction with an adequate level of phase oversampling to prevent any wrap-around artifacts. Instruct the patient to breathe gently during the image acquisition. Use free breathing respiratory-gated sequences or radial k-space sequences (e.g., BLADE T2).

MRI Large abdomen and Pelvic Masses and protocol and planing of coronal scans

Parameters

TR

4000-5000

TE

110

FLIP

130

NEX

2

SLICE

5MM

MATRIX

384X320

FOV

380-400

PHASE

R>L

GAP

10%

TI

130

Now, prepare the injector to administer the IV gadolinium DTPA injection. The document below provides access to the recommended dosage of gadolinium DTPA injection, as advised by the manufacturer.

T1 VIBE DIXON 3D 4mm coronal dynamic 1 pre 8 post free breathing

Plan the coronal T1 VIBE DIXON 3D block on the sagittal plane and align the positioning block vertically across the abdomen. Verify the positioning block in the other two planes. In the axial plane, plan the block horizontally across the abdomen, as shown. Ensure that the slices cover the entire pelvic and abdominal mass, extending from the anterior to the posterior. The field of view (FOV) should be sufficiently large to encompass the mass, typically ranging from 350mm to 400mm. Use a right-to-left phase direction with an adequate level of phase oversampling to prevent any wrap-around artifacts. Instruct the patient to breathe gently during the image acquisition. Use free breathing respiratory-gated sequences or radial k-space sequences (e.g., BLADE T2).

T1 VIBE DIXON 3D coronal dynamic abdomen and pelvis protocol and planning
A dynamic VIBE 3D DIXON sequence comprises nine 3mm 3D scans, with a 10-second delay between the first and second scan for contrast injection. It is essential to administer the contrast injection following the initial run of the dynamic sequence.

Parameters

TR

4-5

TE

2-3

FLIP

10

NEX

1

SLICE

4 MM

MATRIX

384X320

FOV

350-400

PHASE

R>L

DYNAMIC

9 SCANS

IPAT

ON