LIVER MRI PROTOCOL-Detect&characterize focal liver lesions


Liver 

To detect and characterize focal liver lesions
  • Scout (multiple planes)
  • T2 weighted Axial with fat suppression
  • T1 out of phase Spoiled Gradient Echo (SGE) Axial
    • If the lesion is bright on T1 do a fat saturated T1 Axial
  • T1 in phase SGE Axial
Post Contrast (0.2ml/kg rapid injection followed by 10 ml saline flush)
    • T1 In Phase FLASH Axial at :-
      • End of saline flush,
      • 45 seconds post contrast
      • 3 minutes post contrast
      • 10 minutes post contrast (optional)
      • MRCP axial, RAO for Hepatic ducts, LAO for pancreatic duct
Notes
  • The pre-contrast images locate lesions and provide T1 and T2 weighted information.
  • Out of Phase (OOP) FLASH images display fatty infiltration and adrenal adenomas.
  • The post contrast images help classify the nature of the lesion.
  • The immediate post contrast image is very time critical, and is the most valuable.
  • The rapid injection requires good venous access. Have the 20 G Jelco in situ before the patient is placed in the bore ( before they enter the room if possible).

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