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1.0T Routine shoulder with ST Extremity M coil - Saint Barnabas

ExamCard
Smith, Robert, R.T. B.S. (R)(MR)(CT) Livingston, N.J. Saint Barnabas Ambulatory Care Center USA
Herwerden, Rick Philips Healthcare Philips Global

1.0T Routine shoulder with ST Extremity M coil - Saint Barnabas Ambulatory Care Center

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ExamCard purpose

Routine shoulder imaging utilizing the 2-element ST Extremity M coil to visualize anatomy, tendon and ligament tears. Using the ST Extremity coil and proper positioning, especially with larger patients encountered with the Panorama 1.0T, provides increased SNR and improved shoulder coverage.

ExamCard overview

Shoulder MPF M coil
Scan 1Survey
Scan 2Reference Scan
Scan 3PD SPAIR Ax
Scan 4T2 FFE Ax
Scan 5PD SPIR Cor
Scan 6T2 TSE Cor
Scan 7T2 SPAIR Sag
Scan 8T1 TSE Sag

Scan 1: Survey images in 3 orthogonal planes are obtained. Position the shoulder at isocenter by positioning the patient in a semi-oblique plane.

 

Scan 2: The sensitivity information obtained is used throughout the exam in all CLEAR and SENSE reconstructions.

 

Scan 3: AXIAL PD SPAIR - sequence to visualize the Glenoid Fossa, Humeral Head, posterior and inferior Labrum and articulating cartilage. A PD-weighted TSE sequence with spectral fat suppression is applied to enhance cartilage and fluid visualization.

 

Scan 4: AXIAL T2 FFE - In-phase selectable TE for cartilage visualization.

 

Scan 5: CORONAL PD TSE SPIR - PD-weighted Turbo Spin Echo sequence. Coronal plane for visualization of the rotator cuff, superior and inferior labrum, impingement and AC joint. SPIR fat saturation is applied to enhance cartilage and fluid visualization.

 

Scan 6: CORONAL T2 TSE. True T2-weighted contrast demonstrates excellent fluid signal to demonstrate tears, muscle atrophy and tendinosis.

 

Scan 7: SAGITTAL T2 TSE SPAIR - Fat suppressed for improved fluid signal. Structures evaluated include RCT, glenoid fossa and gleno-humeral ligament.

 

Scan 8: SAGITTAL T1 TSE- To show hypointense signal in sclerosis and subchondral edema.

 

 

PD TSE SPAIR Axial TSE Factor 8<br>
FOV 170, NSA 2, TR 2104,       256/400R, TE 12, <br>scan time 3:09 min.T2 FFE Axial <br>FOV 170, NSA 2, TR 775,        256/448R, TE 21, <br>scan time 4:59 min.PD TSE SPIR Coronal <br> TSE Factor 6<br>
FOV 160, NSA 3, TR 1978, 368/400R, TE 14, <br>scan time 2:44 min.
PD TSE SPAIR Axial
T2 FFE Axial
PD TSE SPIR Coronal
TSE Factor 8
FOV 170, NSA 2, TR 2104, 256/400R, TE 12,
scan time 3:09 min.

FOV 170, NSA 2, TR 775, 256/448R, TE 21,
scan time 4:59 min.
TSE Factor 6
FOV 160, NSA 3, TR 1978, 368/400R, TE 14,
scan time 2:44 min.
T2 TSE Coronal TSE Factor 12<br>
FOV 160, NSA 4, TR 3658,   256/512R, TE 110,         <br>scan time: 3:36 min.T2 SPAIR Sagittal TSE Factor 8<br>
FOV 170, NSA 2, TR 4682, 256/288R, TE 70,            <br>scan time: 3:17 min.T1 TSE Sagittal TSE Factor 3<br>
FOV 160, NSA 2, TR 500, 304/400R, TE 15,           <br>scan time: 2:35 min.
T2 TSE Coronal
T2 SPAIR Sagittal
T1 TSE Sagittal
TSE Factor 12
FOV 160, NSA 4, TR 3658, 256/512R, TE 110,
scan time: 3:36 min.
TSE Factor 8
FOV 170, NSA 2, TR 4682, 256/288R, TE 70,
scan time: 3:17 min.
TSE Factor 3
FOV 160, NSA 2, TR 500, 304/400R, TE 15,
scan time: 2:35 min.

Patient preparation

Positioning of the ST Mulit-Purpose M or ST Extremity M coil is key to a successful routine shoulder exam. The 1st element or loop is placed on top of the shoulder and the 2nd element or loop will overlap the first coil and should be placed along side the shoulder/ humerus. This position provides optimal IQ and SNR with deep penetrating signal. Immobilization should be provided with a broad Velcro strap wrapping around the patient and affected shoulder. Positioning and immobilization of the shoulder is demonstrated in the following images.

 



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ExamCard
Panorama HFO
Release 2
Pulsar
Musculoskeletal, Shoulder
 

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