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3.0T TX Fast pediatric acute RLQ abdominal pain exam - UoVermont

ExamCard
Gonyea, Jay, B.Sc. University of Vermont at Fletcher Allen Healthcare • USA

3.0T TX fast pediatric acute RLQ abdominal pain exam - University of Vermont

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ExamCard description

This release 3.2 ExamCard for an Achieva 3.0T TX system was developed to provide an alternative to using Computed Tomography for imaging children with acute right lower quadrant pain. It is designed for imaging the pediatric and young adult population without sedation.

To make this protocol successful, we were able to avoid using time intensive respiratory triggering or gating by instead using shallow breathing. Since children have a smaller anterior to posterior dimension, their chest and abdomen do not tend to rise and fall as dramatically as in an adult, and as a result their motion causes less slice misregistration. A young child is unlikely to get through a 45 minute MRI examination, without the use of general anesthesia or sedation.

ExamCard overview

 Click on the ExamCard overview to enlarge it.
Click on the ExamCard overview to enlarge it.

ExamCard includes:

Survey: 0:30 min.

SENSE Reference scan: 0:30 min.

Coronal 2D T2W single-shot TSE: 0.91x0.91 mm in-plane resolution (acquired), 3 mm slice thickness, 0.6mm gap, 30 slices (1:43 min.)

Sagittal 2D T2W single-shot TSE: 0.91x0.91 mm in-plane resolution (acquired), 2 mm slice thickness, 0.5mm gap, 56 slices (2:28 min)

Axial 2D T2W single-shot TSE SPAIR: 0.8x0.8 mm in-plane resolution (acquired), 3 mm slice thickness, 1 mm gap, 45 slices (1:35 min.)

(Optional) Axial 2D T2W single-shot TSE: 0.8x0.8 mm in-plane resolution (acquired), 3 mm slice thickness, 1mm gap, 45 slices (1:29 min.)

Total scan time for this ExamCard is 08:18 min.

ExamCard images

Click on an image to enlarge it.
 T2w coronal
0.9 x0.9 mm T2w sagittal
0.9 x 0.9 mm
T2w coronal 0.9 x0.9 mm
T2w sagittal 0.9 x 0.9 mm
 T2w SPAIR axial
0.8 x 0.8 mm
T2w SPAIR axial 0.8 x 0.8 mm

Patient preparation

The SENSE XL Torso coil was used. The patient is instructed to avoid deep breaths and to lie as still as possible. Communication is maintained with the subject throughout the imaging process. We do allow a parent to accompany very young children into the magnet room. Clear, positive communication is a key to success!

Other

It is worth pointing out that for our research study, we adjusted the SAR Mode to "High", so that we could scan faster with a decreased TR. If you choose to use "High" SAR Mode, it should be done under the supervision of a qualified physician. The patient should be monitored closely for excessive heating and they should not be scanned for an excessive period of time.

References

For additional information on our technique, please see
Ultrafast 3-T MRI in the Evaluation of Children with Acute Lower Abdominal Pain for the Detection of Appendicitis
American Journal of Roentgenology, 198, 1424-1430, June 2012


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ExamCard
Achieva 3.0T
Release 3
Abdomen, Acute pain, Body, Pediatric, Pelvis, SENSE XL Torso coil
 

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