Chest, abdomen, or pelvis MRI with or without contrast MRI(superficial mass MRI protocol)

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 Indications: abdominal or chest wall lesion.

 Sequences: place fiducial over area of concern; use smallest possible coil.

• Axial 2-D FLASH in-phase.
• Axial 2-D FLASH out-of-phase.
• Axial breath-hold T2 FSE
• Axial STIR FSE
• Post-Gd axial 2-D FLASH with fat saturation. 

Comments:

·        Acquire pre-contrast 2-D FLASH separately to enhance signal-to-noise ratio. 

·        Use EKG gating or flip phase/frequency if lesion is anterior to the heart. 

·        Gadolinium can be skipped if lesion has appearances of lipoma.  If given, administer 40 cc Gd at 2 cc/sec.  For MultiHance, 20 cc total.

·        Suggested post-Gd delays: chest 25 sec, abdomen 30 sec, pelvis 35 sec.  Better to wait too long than not long enough.  

Dictation template:

Axial 2-D FLASH in- and out-of-phase, axial breath-hold T2 FSE, axial STIR FSE.  Optional 0.1-0.4 mmol/kg of intravenous Gadolinium contrast (up to 40 mL) may be given, followed by axial 2-D FLASH with fat saturation acquired over the lesion of concern.