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3.0T MobiFlex dual injection - University Cologne

ExamCard
Gossmann, Axel, M.D. Cologne, University of Cologne
Nijenhuis, Marco Philips Healthcare

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Examcard purpose

This ExamCard outlines a CE-MRA protocol for the assessment of the peripheral vasculature at 3.0 Tesla. A dual injection approach is chosen to avoid venous contamination at the lower leg. The lower legs are visualized after a separate injection.

 

True resolution (mm):

  • Pelvis station: 1.23x1.61x1.70 (oc)
  • Upper station: 1.23x1.61x1.70 (oc)
  • Knee  station: 0.87x0.87x1.10 (oc)
  • Lower station: 0.87x0.87x0.90 (oc)

 

Features used in this ExamCard:

Geolinks are applied between the different stations to group the three stations. This grouping is recognized by the VolumeView package, allowing a single-button MIP postprocessing for all stations.

ScanAlign is applied for planning all stations as one volume and it is used to ensure a certain overlap between the stations.

Manual or automatic table movement. Automatic table movement can be chosen for an easy workflow of MobiFlex.

Patient preparation

  • Position the patient in the MobiFlex support
  • The knee cushion has to be positioned a little above the back of the knees. 
  • Immobilize ankles and knees with straps .  

Injection protocol

Timing at Lower leg:

  • 2 ml 0.5M @ 1ml/s
  • 20 ml flush @ 1ml/s

 

Lower leg:

  • 10 ml 0.5M @ 1ml/s
  • 25 ml flush @ 1ml/s

 

Abdomen -> Upper leg (second procedure):

  • 15 ml 0.5M Gd @ 1.0 ml/s
  • 10 ml 0.5M Gd @ 0.6 ml/s
  • 20 ml flush @ 0.6 ml/s

 

Workflow

  1. Start SURVEY.
  2. Fuse the orthogonal MIP's with Mob View and save images to database.
  3. Load the saved MobiView images in the planning environment.
  4. Plan the MobiFlex, BolusTrak and the Timing sequences on the fused images.
  5. The Timing sequence has to be planned at the level off the popliteal artery.
  6. BolusTrak has to be planned at the abdominal level.
  7. Prepare the contrast injection for the Timing protocol (see above).
  8. Start the injection and the Timing sequence simultaneously. Determine the timing delay.

  9. Start the Lower_Leg grouped sequence. The First sequence is for subtraction purpose.
  10. After the first sequence a manual start is required to start the second sequence.
  11. Program the contrast injector for injection protocol Lower leg (see above).
  12. The Lower leg contrast sequence has to be started via a manual start according the timing delay.

  13. After reconstruction the Abdomen-> Upperleg procedure can be started.
  14. The ExamCard will pop up a manual start at the level of the Abdomen procedure. Give an Expiration command. Press the proceed button.
  15. Prepare the contrast injection for the Abdomen -> Upper leg procedure (see above).
  16. Open Autoview window.
  17. Start the BolusTrak sequence. At the moment a subtracted image is available within the Autoview window the contrast injection has to be started.
  18. Press the fast next scan at the moment the contrast is at the level of the bifurcation
  19. Immediately give a breathing command and press proceed again.
  20. From this point on the procedure will continue automatically.

  21. Use the VolumeView package to create MIPs of the subtracted result. You can use propagation over stations (propagate tab, propagate stations, single axis) for fast workflow.
  22. The resulting MIPs can be loaded and fused in the MobiView package. Save the images to the database. These images can be exported to e.g. PACS systems.


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Jan 24, 2006

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ExamCard
Achieva 3.0T
Release 1
Peripheral MRA, Vascular
 

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