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Imaging brain/carotids of very large patient

Application Tip
Macauley, Robert, MBA, ARRT. R,QM,CT,MR Scottsdale Healthcare USA

If a patient is too wide to fit in the bore for brain MRI, a solution may be to place the patient's arms above the head.

 

If a patient's head is too large to fit in a regular head coil, using the SENSE Flex L coil may yield a very acceptable study that would otherwise go unscanned.

Patient positioning

Position the patient supine with the arms extending above his head. Support the patient's arms to diminish shoulder discomfort. The Achieva scanner is very "roomy" for this approach, there is no dock station for coil plugs to get in the way.

 

Use the SENSE Flex L coil in two different positions, see photos of model.

For brain imaging, one strap is applied to hold the head still and hold coils in place at the same time. Pay attention to insulate coil cables.

Positioning for brain Positioning for carotids
Positioning for brain
Positioning for carotids

Example

A patient presented at Thomson Peak Hospital for a brain/carotid study. He was tall and 350 lbs with very broad shoulders (so larger than the person modeling in the above photos). He could not fit into the bore without placing his arms above the head. He could not fit into regular head coils due to the size of his head. The patient was positioned as described above.

 

T1 sag brain T2 ax brain MRA brain
T1 sag brain
T2 ax brain
MRA brain
2D carotids 3D carotids lower 3D carotids
2D carotids
3D carotids lower
3D carotids

ExamCards used

See the help text in the ExamCards for more details on positioning.

 

Particularly when performing carotid MRA of large people, we usually see better image quality when using the 3D scan.  

 
 

ExamCard for 1.5T Brain with arms above head with SENSE Flex L coil:

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 ExamCard for MRI Brain with arms above head with SENSE Flex L coil <br><br>
ExamCard for MRI Brain with arms above head with SENSE Flex L coil

 

ExamCard for 1.5T Head MRA with arms above head with SENSE Flex L coil:

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 ExamCard for MRA Head with arms above head with Flex L coil
ExamCard for MRA Head with arms above head with Flex L coil

Summary

Instead of turning this patient away as incompatible for MRI, the study could still be done using the described approach, enabled by the versatility and flexibility of Achieva 1.5T and the Philips coils.

 

This patient had no other option to have the study because he could not fit into the magnet bore with his arms by his side and his head was too large for the dedicated head coils.



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Added:
Jul 9, 2009

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Application Tip
Achieva 1.5T
Release 2.6
Nova, Nova Dual, Pulsar
Brain, Neck, Neuro, Oversize, Vascular
 

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