Liver MRI Protocol

• Haste Axial/Coronal
• Axl T2 Fat Sat BH
• T1 Axial IN/OUT Phase
• VIBE/LAVA Axial

Weight based Gadolinium contrast-Timing run

• VIBE/LAVA Axial 3phase((0, 60, 180 sec)
• VIBE/LAVA Coronal Delayed
• VIBE/LAVA Axial 90 MIN (optional)

HEPATIC CONTRAST PHASES

arterial phase : 20 - 25 seconds

portal venous phase : 60 - 70 seconds

equilibrium phase : 3 - 5 minutes

hepatobiliary delayed phase : 10 - 30 minutes with and without fat sat

later delayed phase : 1 hour + / - 3 hours in some institutions

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LIVER MRI PROTOCOL

LIVER MRI PROTOCOL


3-plane localizer
Coronal SSFSE (single-shot fast spin-echo)
 Axial SSFSE
Axial dual in-phase and out-of phase
Axial 3D Dynamic Gd (FAME)
Post-Gd Coronal T1

Liver donor Special Sequence:

Fast 2D TOF-

 It produces excellent vascular motion suppression with respiratory compensation (ROPE) which is especially useful in patients who cannot breathe hold

POST CONTRAST T1 2D or 3D 

arterial phase : 20 - 25 seconds

portal venous phase : 60 - 70 seconds

equilibrium phase : 3 - 5 minutes

hepatobiliary delayed phase : 10 - 30 minutes with and without fat sat

later delayed phase : 1 hour + / - 3 hours in some institutions

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To detect and characterize focal liver lesions

MRI Imaging Characteristics of Liver Mass Lesions

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).