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Ingenia 1.5T Brain non-contrast for ED - SJHMC

ExamCard
Karis, John, M.D. St. Joseph's Hospital, Barrow Neurological Institute • USA
Mahl, Mark St. Joseph's Hospital, Barrow Neurological Institute • USA

Download ExamCard Ingenia 1.5T Brain non-contrast for ED:

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ExamCard purpose

St. Joseph's Hospital and Medical Center has developed fast, targeted ExamCards to support the fast, confident decisions that need to be made in their Neuro Emergency Department (ED).

 

This ExamCard is created for use in the ED on an Ingenia 1.5T with Release 5.1.9 for patients with:

  • cognitive impairment
  • confusion
  • dementia 
  • headache when non-SAH suspected
  • mental status changes
  • seizures (children)
  • trauma

 

View the full Neuro ED MRI ordering guide of SJHMC

 

 

The standard sequences in the ExamCard add up to a total scan duration of less than 9 minutes.

 

In addition, an optional AX T2 TSE scan was added at the end of the ExamCard for use in MS patients. Including the additional T2W sequence, the ExamCard takes 11 minutes.

ExamCard overview

Total ExamCard scan time is 11:03 minutes.

The ExamCard includes SmartLine postprocessing steps for the DWI scan.

The SmartLine steps are collapsed in the ExamCard overview.

ExamCard images

These images are from a patient with previously resected metastatic focus from the posterior fossa, who presented to the ED with symptoms of meningismus and headache.
AX FLAIR_longTR Scan time 2:45 min. <br> 
TR 11000 ms, TE 140 ms, TI 2800 ms <br> 
FOV  230 x 197 x 143 mm <br> 
Voxel size 0.45 x 0.45 x 5.0 mm <br> 
24 slices, SENSE factor 1.5 <br>AX GRE (T2* TFE) Scan time 00:51 min. <br> 
TR 4278 ms, TE 129 ms <br> 
FOV  230 x 197 x 143 mm <br> 
Voxel size 0.9 x 0.9 x 5.0 mm <br> 
24 slices, SENSE factor 2.0 <br>
AX FLAIR_longTR
AX GRE (T2* TFE)
Scan time 2:45 min.
TR 11000 ms, TE 140 ms, TI 2800 ms
FOV 230 x 197 x 143 mm
Voxel size 0.45 x 0.45 x 5.0 mm
24 slices, SENSE factor 1.5
Scan time 00:51 min.
TR 4278 ms, TE 129 ms
FOV 230 x 197 x 143 mm
Voxel size 0.9 x 0.9 x 5.0 mm
24 slices, SENSE factor 2.0

Comparison with a prior MRI examination

Comparing the MRI exam done in the ED to images from a previous standard, long time, clinical MRI study with a higher resolution shows the good image quality of the FLAIR in the ED MRI exam.

FLAIR from prior standard MRI exam FLAIR from ED MRI examination
FLAIR from prior standard MRI exam
FLAIR from ED MRI examination

Patient preparation

Position the patient head first, supine on the patient support. Place the head of the patient on the dS Base. Provide the patient with the knee support, hearing protection and the nurse call before positioning the dS Head top on the dS Base.

Postprocessing / analysis

SmartLine postprocessing steps have been added to the DWI scan.

First of all a Diffusion Registration is performed.

From the Diffusion Registered images

  • ADC maps and
  • eADC maps are created.

 

In addition an

  • ImageAlgebra subtraction postprocessing step has been added to subtract the b0 images from the b1000 I images.

 

The SmartLine steps start automatically without user interaction after the reconstruction of the original image series.

Related reading



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ExamCard
Ingenia 1.5T
Release 5
ADC, Brain, Diffusion, diffusion weighted imaging, dStream, DWI, Emergency Department, Head, Neuro
 

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