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1.5T Brain - Trier

ExamCard
Busch, Hans-Peter, M.D. Trier, Brüderkrankenhaus
Hoffmann, Georg Trier, Brüderkrankenhaus

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ExamCard description

This ExamCard is used in Krankenhaus der Barmherzigen Brueder in Trier, Germany, when brain infarction is suspected or detected.

ExamCard overview

ExamCard overview

The basic ExamCard that is performed if infarction is suspected, contains axial T2-weighted TSE, axial T1-weighted SE and coronal T2-weighted FLAIR, all providing full brain coverage. Additionally, a sagittal T2-weighted TSE through the brainstem is performed. Single shot diffusion weighted images are also acquired, as they might reveal infarcted regions already within a few hours.

 

If the infarction is older than 8 days, the ExamCard is extended with a post-contrast T1-weighted SE sequence and angiography is performed.

Axial T2W_TSE Infarcted regions are visible.Coronal T2W_FLAIR Coronal images in two locations show several infarcted regions.Axial T1W_SE
Axial T2W_TSE
Coronal T2W_FLAIR
Axial T1W_SE
Infarcted regions are visible.
Coronal images in two locations show several infarcted regions.
Sagittal T2W_TSE Axial DWI_SSh Single shot diffusion. B-value 800.
SENSE is used to reduce echo train length.3D_inflow Multi-chunk sequence with SENSE.
Sagittal T2W_TSE
Axial DWI_SSh
3D_inflow
Single shot diffusion. B-value 800. SENSE is used to reduce echo train length.
Multi-chunk sequence with SENSE.

ExamCard features

Contrast-enhanced angiography of the Circle of Willis is included in this ExamCard. To ensure an easy workflow for this procedure, the ExamCard is paused prior to the start of the BolusTrak timing sequence. Scanning is not resumed until all preparations for the contrast enhanced MRA are complete.

 

Both 3D_CE_MRA and BolusTrak sequence are added to the ExamCard.

The 3D_CE_MRA is a two-dynamic sequence in which the dynamics are split. This sequence and the BolusTrak sequence are grouped together, to make sure that none of these sequences can be started before they are all planned.

 

By edit group, the BolusTrak-sequence is positioned in between the split dynamics. The number of dynamics of the first part of the 3D_CE_MRA is reduced to 0. This results in performing preparation phases only.

 

Subsequently, the BolusTrak timing sequence is acquired. And, finally, the actual high resolution 3D_CE_MRA is acquired. The BolusTrak delay time is reduced to a minimum since the preparation steps are performed already.

 

Workflow

The ExamCard is paused prior to the acquisition of the contrast enhanced MRA of the Circle of Willis. A pop-up message will appear to announce this pause.

 

Position the volume of the high resolution CE_MRA in the region of the Circle of Willis. The BolusTrak sequence should be positioned lower to cover the region of the carotid arteries. The maximum allowed difference in feet-head position is 15 cm. Larger distance will require table movement, which in turn lengthens the switching time between the BolusTrak sequence and the actual high resolution CE_MRA.

 

Open the autoview window. The results of the 2D-BolusTrak sequence will be displayed in this window in real-time.

 

Start scan to start the acquisition of the entire group. The preparation phases of the 3D_CE_MRA sequence are now performed. Upon completion of the preparation phases, a pop-up message will appear: "allow table movement". Table movement should NOT be allowed, as this will increase the delay time after selecting "fast next scan". The 2D-bolusTrak scan is acquired with an off-centre.

 

A manual start is included in the 2D-BolusTrak scan, to allow triggering of the contrast injection with the start of the scan. During the acquisition of the BolusTrak timing sequence, another pop-up message will appear to enable "fast next scan". Make sure that this window is the active window. This again will reduce the switching delay time to a minimum.

 

As soon as the contrast bolus arrives in the desired level of the carotids, "proceed" is selected in the pop-up message. The acquisition of the BolusTrak is ended and the acquisition of the high-resolution CE-angio is started.

 

BolusTrak timing sequence Upon arrival of the contrast bolus, fast next scan is used to start the high resolution CE-MRA.3D_CE_MRA Axial MIP. Radial reconstructions.
BolusTrak timing sequence
3D_CE_MRA
Upon arrival of the contrast bolus, fast next scan is used to start the high resolution CE-MRA.
Axial MIP.
Radial reconstructions.


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Apr 29, 2005

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ExamCard
Achieva 1.5T
Release 1
Pulsar
Brain, Neuro, Vascular
 

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