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).