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3.0T Wrist - Mayne Clinical Research Imaging Centre

ExamCard
Shnier, Ron, M.D. Symbion Research Clinical Imaging Center Australia
Hughes, Kathleen Symbion Research Clinical Imaging Center Australia

3.0T Wrist with SENSE Wrist coil - Mayne Clinical Research Imaging Centre

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ExamCard purpose

Routine imaging for wrist injury with suspected ligament or cartilage damage, arthritis, or chronic pain of unknown origin.

 

For imaging lesions and/or soft tissue masses, add post-contrast fat saturated T1-weighted sequences in the axial and coronal plane. Post-contrast imaging is also helpful for monitoring and assessing early stages of possible avascular necrosis. 

ExamCard overview

Scan 1Survey1
Scan 2Survey2 MST
Scan 3Ref SWrist
Scan 4T2W /SPAIR /AX
Scan 5T1W/AX
Scan 6T2W/ SPAIR /COR
Scan 7PDW/COR
Scan 8PDW/SAG

ExamCard descriptions

1. Survey 1

Place wide restraint on tabletop. This will wrap around the patient and coil, and secure the wrist.

Position the patient supine. The wrist should be down at the patient's side with the palm surface against the thigh. Position the Wrist coil over the wrist using both anterior and posterior cushions inside the coil.

Survey 1 uses the Quadrature Body coil with transverse images for general localization at large slice thickness and 400 mm FOV. RL Offcenter is set to 90-100. If the wrist is not within this FOV, move the patient so that the wrist is closer to the isocenter.

 

2. Survey 2

Survey 2 contains three imaging planes with smaller slice thickness and 5-7 slices per plane to fully visualize the wrist. Angle the three planes to achieve true axial, coronal and sagittal planes.

Check the survey images for accurate coil positioning in all three planes: the joint should be easily visible on all three planes.

 

3. Ref SENSE Wrist coil

Reference map for application of the CLEAR filter and/or SENSE technique. Although the coil is small, CLEAR does make a positive contribution to image uniformity.

 

4. T2W/SPAIR/AX

2 mm images with the SPAIR fat suppression technique. Echo time is set to 60 ms with a SPAIR TI of 120 ms. TR should remain around 4700 ms to achieve heavy T2 weighing. The TR/TE and TI times can be altered for less T2 weighting and less intense fat saturation. A REST slab is added above the wrist to reduce flow artefacts from blood vessels. Volume shim can be added, if fat suppression inconsistencies are found per patient.

 

5. T1W/AX

2 mm slices for anatomical detail. In this protocol the number of packages is set to 3 to ensure a true T1W TR value. The TSE factor is 3, with a linear profile order to reduce blurring at high resolution.

 

6. T2W/SPAIR/COR

The acquisition plane used is actually listed as sagittal, but with the patients wrist positioned flat against the thigh, the resulting plane will be coronal. The foldover direction is AP, as would be normally found in sagittal imaging. 2 mm coronal imaging is obtained with a TR/TE/SPAIR TI of around 2900/60/120 ms.

 

7. PDW/COR

The acquisition plane used is actually listed as sagittal, but with the patient's wrist positioned flat against the thigh, the resulting plane will be coronal. The foldover direction is AP as would be normally found in sagittal imaging. DRIVE is used with TR/TE of 1580/32 ms. TSE factor 6 with linear profile order provides crisp imaging. Echo spacing should not go above 9 ms.

 

8. PDW/SAG

The real acquisition plane is listed as coronal, but with the wrist positioned against the thigh, the resulting imaging plane will be sagittal. The RL foldover direction is used. PD-weigting is obtained with the use of DRIVE and TR/TE of around 2000/33 ms.

Images

T2W/SPAIR/AX T1W/AX T2W/SPAIR/COR
T2W/SPAIR/AX
T1W/AX
T2W/SPAIR/COR
PDW/COR PDW/SAG
PDW/COR
PDW/SAG


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ExamCard
Intera 3.0T
Musculoskeletal, Wrist
 

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