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Ingenia 1.5T C/T spine non-contrast for ED - SJHMC

ExamCard
Karis, John, M.D. St. Joseph's Hospital, Barrow Neurological Institute • USA
Mahl, Mark St. Joseph's Hospital, Barrow Neurological Institute • USA

Download ExamCard for C-spine:

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Download ExamCard for T-spine:

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ExamCard purpose

St. Joseph's Hospital and Medical Center has developed fast, targeted ExamCards to support the fast, confident decisions that need to be made in their Neuro Emergency Department (ED).  

 

SJHMC uses mDIXON TSE extensively in spine imaging in the Emergency Department. It's particularly nice in that it is very robust with regards to susceptibility type of problems that would come up with traditional spectral fat-saturation images; this is a great advantage of the mDIXON technique.

 

 

 

These ExamCards are created on an Ingenia 1.5T system with Release 5.1.9.

   

The Cervical spine ExamCard was created to be used for patients with:

  • arm/shoulder pain and/or weakness
  • degenerative disease 
  • disc herniation
  • neck pain
  • post-op fusion
  • reticulopathy
  • spondylolisthesis
  •    

The Thoracic spine ExamCard was created to be used for patients with:

  • back pain and
  • compression fracture (no hx malig/mets)
  • degenerative disease 
  • disc herniation
  • reticulopathy
  • trauma


In both ExamCards an alternative AX T2 TSE (METAL) scan of four minutes scan duration was added for use in patients post surgery.

 

 

View the full Neuro ED MRI ordering guide of SJHMC

ExamCard overview

C-Spine ExamCard Total ExamCard scan time is 13:35 min.  without the C AX T2 TSE (METAL) scan.
SmartLine postprocessing steps are included for the T2W mDIXON and mFFE scans.T-Spine ExamCard Total ExamCard scan time is 13:24 min.
without the C AX T2 TSE (METAL) scan.
SmartLine post-processing steps are included for the T2W mDIXON and mFFE scans.
C-Spine ExamCard
T-Spine ExamCard
Total ExamCard scan time is 13:35 min. without the C AX T2 TSE (METAL) scan. SmartLine postprocessing steps are included for the T2W mDIXON and mFFE scans.
Total ExamCard scan time is 13:24 min. without the C AX T2 TSE (METAL) scan. SmartLine post-processing steps are included for the T2W mDIXON and mFFE scans.

ExamCard images cervical spine

C SAG T1W TSE Scan time 4:36 min. <br> 
TR 400 ms, TE 7.5 ms <br> 
FOV  130 x 228 x 43 mm <br> 
Voxel size 0.45 x 0.45 x 3.0 mm <br> 
13 slices, SENSE factor 1.0 <br>C AX T2 mFFE (NO METAL) Scan time 4:46 min. <br> 
TR 3317 ms, TE 120 ms <br> 
FOV  200 x 153 x 53 mm <br> 
Voxel size 0.39 x 0.39 x 3.0 mm <br> 
31 slices in 2 stacks, SENSE factor 1.60 <br>
C SAG T1W TSE
C AX T2 mFFE (NO METAL)
Scan time 4:36 min.
TR 400 ms, TE 7.5 ms
FOV 130 x 228 x 43 mm
Voxel size 0.45 x 0.45 x 3.0 mm
13 slices, SENSE factor 1.0
Scan time 4:46 min.
TR 3317 ms, TE 120 ms
FOV 200 x 153 x 53 mm
Voxel size 0.39 x 0.39 x 3.0 mm
31 slices in 2 stacks, SENSE factor 1.60
C SAG T2W mDIXON TSE fat image Scan time 3:41 min. <br> 
TR 2602 ms, TE 48 ms <br> 
FOV  130 x 233 x 49 mm <br> 
Voxel size 0.41 x 0.41 x 3.0 mm <br> 
15 slices, SENSE factor 1.0 <br>C SAG T2W mDIXON TSE water image Scan time 3:41 min. <br> 
TR 2602 ms, TE 48 ms <br> 
FOV  130 x 233 x 49 mm <br> 
Voxel size 0.41 x 0.41 x 3.0 mm <br> 
15 slices, SENSE factor 1.0 <br>
C SAG T2W mDIXON TSE fat image
C SAG T2W mDIXON TSE water image
Scan time 3:41 min.
TR 2602 ms, TE 48 ms
FOV 130 x 233 x 49 mm
Voxel size 0.41 x 0.41 x 3.0 mm
15 slices, SENSE factor 1.0
Scan time 3:41 min.
TR 2602 ms, TE 48 ms
FOV 130 x 233 x 49 mm
Voxel size 0.41 x 0.41 x 3.0 mm
15 slices, SENSE factor 1.0

Patient preparation

Position the patient head first, supine on the patient support. Place the head of the patient on the dS Base. Provide the patient with the knee support, hearing protection and the nurse call.

It is recommended to position the dS Head/Neck top on the dS Base to increase the signal in the scans.

Postprocessing / analysis

SmartLine postprocessing steps, ImageAlgebra, have been added to the

  • T2W_mDIXON_TSE scan to reconstruct a seperate image series of the fat images and of the water images. This enables easier viewing of the data on peripheral workstations and PACS systems.
  • mFFE (No METAL) scan to cumulate the multiple FFE echoes into one image series.

 

 

The SmartLine steps start automatically without user interaction after the reconstruction of the original image series.

Related reading



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ExamCard
Ingenia 1.5T
Release 5
Cervical spine, dStream, Emergency Department, mDIXON, mDIXON TSE, Neuro, Spine, Thoracic spine
 

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