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Ingenia 1.5T Lumbar spine with 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

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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 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.

 

This ExamCard is created for use in the ED on an Ingenia 1.5T with Release 5.1.9 for patients with:

  • compression fracture (hx malig/mets)
  • discitis/osteomyelitis
  • post-op
  • tumor/mass/cancer/mets
  • vertebroplasty planning (with hx malig)

 

The ExamCard makes use of a T2W mDIXON TSE scan for pre-contrast imaging and a T1 mDIXON TSE scan for post-contrast imaging.

 

 

View the full Neuro ED MRI ordering guide of SJHMC

ExamCard overview

Total ExamCard scan time is 16:31 minutes.

 

The ExamCard includes SmartLine postprocessing steps for the T2W mDIXON and T1W mDIXON TSE scans.

The SmartLine steps are collapsed in the ExamCard overview.

ExamCard images

T2W_mDIXON_TSE fat image Scan time 2:45 min. <br> 
TR 2500 ms, TE 90 ms <br> 
FOV  160 x 261 x 57 mm <br> 
Voxels 0.41 x 0.41 x 4.0 mm <br> 
13 slices, SENSE factor 1.7 <br>T2W_mDIXON_TSE water image Scan time 2:45 min. <br> 
TR 2500 ms, TE 90 ms <br> 
FOV  160 x 261 x 57 mm <br> 
Voxels 0.41 x 0.41 x 4.0 mm <br> 
13 slices, SENSE factor 1.7 <br>
T2W_mDIXON_TSE fat image
T2W_mDIXON_TSE water image
Scan time 2:45 min.
TR 2500 ms, TE 90 ms
FOV 160 x 261 x 57 mm
Voxels 0.41 x 0.41 x 4.0 mm
13 slices, SENSE factor 1.7
Scan time 2:45 min.
TR 2500 ms, TE 90 ms
FOV 160 x 261 x 57 mm
Voxels 0.41 x 0.41 x 4.0 mm
13 slices, SENSE factor 1.7
L SAG T1 Scan time 2:18 min. <br> 
TR 435 ms, TE 9.0 ms <br> 
FOV  160 x 258 x 57 mm <br> 
Voxels 0.49 x 0.49 x 4.0 mm <br> 
13 slices, SENSE factor 1.4 <br>L AX T1 post-contrast Scan time 2:59 min. <br> 
TR 615 ms, TE 6.0 ms <br> 
FOV  160 x 160 x 175 mm <br> 
Voxels 0.31 x 0.31 x 4.0 mm <br> 
40 slices, SENSE factor 1 <br>
L SAG T1
L AX T1 post-contrast
Scan time 2:18 min.
TR 435 ms, TE 9.0 ms
FOV 160 x 258 x 57 mm
Voxels 0.49 x 0.49 x 4.0 mm
13 slices, SENSE factor 1.4
Scan time 2:59 min.
TR 615 ms, TE 6.0 ms
FOV 160 x 160 x 175 mm
Voxels 0.31 x 0.31 x 4.0 mm
40 slices, SENSE factor 1
L SAG T1 mDIXON fat image post-contrast Scan time 3:43 min. <br> 
TR 491 ms, TE 15 ms <br> 
FOV  160 x 260 x 57 mm <br> 
Voxels 0.47 x 0.47 x 4.0 mm <br> 
13 slices, SENSE factor 1 <br>L SAG T1 mDIXON water image post-contrast Scan time 2:45 min. <br> 
TR 2500 ms, TE 90 ms <br> 
FOV  160 x 261 x 57 mm <br> 
Voxels 0.41 x 0.41 x 4.0 mm <br> 
13 slices, SENSE factor 1.7 <br>
L SAG T1 mDIXON fat image post-contrast
L SAG T1 mDIXON water image post-contrast
Scan time 3:43 min.
TR 491 ms, TE 15 ms
FOV 160 x 260 x 57 mm
Voxels 0.47 x 0.47 x 4.0 mm
13 slices, SENSE factor 1
Scan time 2:45 min.
TR 2500 ms, TE 90 ms
FOV 160 x 261 x 57 mm
Voxels 0.41 x 0.41 x 4.0 mm
13 slices, SENSE factor 1.7

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.

Contrast agent

Refer to the contrast agent manufacturer for information on dose and indications for use.

 

A manual start has been added to the ExamCard at the position of the 'L SAG T1 mDIXON' scan, to indicate that the contrast agent should be injected prior to starting the scan.

Postprocessing / analysis

SmartLine postprocessing steps, ImageAlgebra, have been added to the T2W_mDIXON_TSE and L SAG T1 mDIXON scans 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.

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
dStream, Emergency Department, Lumbar spine, mDIXON, mDIXON TSE, Neuro, Spine
 

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