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Ambition 1.5T Pelvic MRA - MCVI

ExamCard
Avila, Carlos, R.T. Baptist Health South Florida • USA
Martinez de Osaba, Uranis, R.T. Baptist Hospital • USA
Vadnais, Alexander Philips Medical Systems • USA

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ExamCard description

At MVCI, this ExamCard is used to examine patients with suspected pelvic congestion. This 1.5T ExamCard was developed on Ingenia Ambition at Release 5.5.

1. Survey: FOV 450 x 450 mm, voxel size 3 x 4 x 10 mm, 15 second breath hold.
  

2. Ax B-TFE: FOV 350 x 380 mm, voxel size 1.5 x 1.5 x 7 mm, C-SENSE factor 1.5, scan duration is 1:34 min., free breathing.
 

3. Ax mDIXON - W pre contrast BH: FOV 300 x 320 mm, voxel size 1.8 x 1.8 x 3 mm, 130 slices broken into 2 stacks with stacks as packages, move table per stack and stack alignment FH being used for ease of planning and decreased artifacts. C-SENSE factor 3.2, 14 second breath hold per stack. 
 
4. 4D TRAK XD BH: FOV 380 x 380 mm, voxel size 1.5 x 1.5 x 4 mm, SENSE P reduction 3, SENSE S reduction 1.5, scan time per dynamic is 2.5 seconds, 33% peripheral density, 30 dynamics, 8 second footprint, central size 15%, backward viewsharing.
  

5. mDIXON MRA - W BH: FOV 430 x 430 mm,voxel size 1.3 x 1.3 x 4 mm, C-SENSE factor 8, breath hold duration 13 seconds. 
  

6. Ax mDIXON - W post contrast BH: same as scan 3, just done post contrast
 

ExamCard Images

Survey Voxels 3 x 4 x 10 mm<br>
FOV 450 x 450 mm <br>
Breath hold 15 sec.Ax bTFE C-SENSE factor 1.5 Voxels 1.5 x 1.5 x 7 mm<br>
FOV 350 x 380<br>
C-SENSE 1.5<br>
Scan time 1:34 min.<br>
Free breathingsource 4D-TRAK XD voxel size 1.5 x 1.5 x 4 mm<br>
FOV 380 x 380 mm<br>
Survey
Ax bTFE C-SENSE factor 1.5
source 4D-TRAK XD
Voxels 3 x 4 x 10 mm
FOV 450 x 450 mm
Breath hold 15 sec.
Voxels 1.5 x 1.5 x 7 mm
FOV 350 x 380
C-SENSE 1.5
Scan time 1:34 min.
Free breathing
voxel size 1.5 x 1.5 x 4 mm
FOV 380 x 380 mm
4D TRAK XD BH MIP mDIXON MRA C-SENSE factor 8.0 Voxels 1.3 x 1.3 x 4 mm<br>
FOV 430 x 430 mm<br>
C-SENSE 8<br>
Breath hold 13 sec.mDIXON Post C-SENSE factor 3.2 Voxels 1.8 x 1.8 x 3 mm <br>
FOV 300 x 320 mm<br>
130 slices broken into 2 stacks<br>
C-SENSE 3.2 <br>
Breath hold 14 sec. per stack
4D TRAK XD BH MIP
mDIXON MRA C-SENSE factor 8.0
mDIXON Post C-SENSE factor 3.2
Voxels 1.3 x 1.3 x 4 mm
FOV 430 x 430 mm
C-SENSE 8
Breath hold 13 sec.
Voxels 1.8 x 1.8 x 3 mm
FOV 300 x 320 mm
130 slices broken into 2 stacks
C-SENSE 3.2
Breath hold 14 sec. per stack

Patient preparation

Patient is asked to void bladder and bowels prior to examination. They are changed into appropriate MRI Safe gown and IV access is started.


The patient is instructed about the breathing commands for the sequences. The patient is informed that during the contrast injection they will be holding their breath for as long as they can, when they can no longer hold their breath they should slowly let the air out and then breathe shallow for the remainder of the sequence.


During the examination AutoVoice is used for all breathing commands except during 4D TRAK XD. During this sequence there are 2 breath holds. The first breath hold, done on in inspiration, is to verify the FOV and image quality before contrast is given. The second breath hold is done by telling the patient to breathe in, breathe out, breathe in, breathe out, breathe in and hold it.


By hyperventilating the patient we have found most patients can hold their breath for the entire duration of the 4D TRAK XD acquisition. Having the patient hold their breath decreases motion in the images and increases the visualization of small arterial-venous malformations.


We have found that a slice thickness of 4 mm compared to 2 mm gave better visualization of venous enhancement

Contrast agent/injection protocol

Weight base dosing is used for this study, given at 3cc / sec for the dose of contrast followed by 3cc / sec for 20 cc of saline flush. Refer to the instructions provided by the manufacturer of the contrast agent thar you are using.

Postprocessing

With 4D TRAK XD subtraction can be done and subsequent MIPs can be performed on a single phase or a movie can be produced by using a single projection on all dynamics.


mDIXON MRA Coronal does not require subtraction and MIPs can also be done on this delayed sequence.



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Aug 16, 2019

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ExamCard
Ambition
Release 5
4D-TRAK XD, Body, Compressed SENSE, mDIXON, mDIXON XD, MRA, Pelvis, Vascular
 

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