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Ingenia 1.5T Brain with 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 with 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:

  • focal neurologic signs/symptoms
  • anosmia
  • cranial nerve lesions
  • dizziness/vertigo
  • headache with focal symptoms
  • IAC/hearing loss
  • infection
  • multiple sclerosis
  • neurofibromatosis
  • neurological deficits
  • pituitary lesion
  • seizures (adult new onset)
  • known tumor/mass/metastases/cancer
  • vascular lesions

     

 

View the full Neuro ED MRI ordering guide of SJHMC

 

 

The pre-contrast scans in the ExamCard add up to a total scan duration of approximately 11 minutes.

Including the additional post-contrast T1W 3D sequence, the ExamCard takes 14 minutes.

 

ExamCard overview

Total ExamCard scan time is 14:00 minutes.

The ExamCard includes SmartLine postprocessing steps for the DWI and sT1W_3D_TFE sequences, which are collapsed in the ExamCard overview.

ExamCard images

These images are from a patient with complaints of transient weakness presented at the ED. In this particular patient an additional pre-contrast sT1W_3D_TFE scan was acquired.
DWI b0 image Scan time 0:40 min. <br> 
TR 3345 ms, TE 89 ms<br> 
b-values b0, b1000 <br>
FOV 232 x 232 x 149 mm <br> 
Voxel size 1.04 x 1.04 x 5.0 mm <br> 
25 slices, SENSE factor 2 <br>DWI b1000 I image Scan time 0:40 min. <br> 
TR 3345 ms, TE 89 ms<br> 
b-values b0, b1000 <br>
FOV 232 x 232 x 149 mm <br> 
Voxel size 1.04 x 1.04 x 5.0 mm <br> 
25 slices, SENSE factor 2 <br>
DWI b0 image
DWI b1000 I image
Scan time 0:40 min.
TR 3345 ms, TE 89 ms
b-values b0, b1000
FOV 232 x 232 x 149 mm
Voxel size 1.04 x 1.04 x 5.0 mm
25 slices, SENSE factor 2
Scan time 0:40 min.
TR 3345 ms, TE 89 ms
b-values b0, b1000
FOV 232 x 232 x 149 mm
Voxel size 1.04 x 1.04 x 5.0 mm
25 slices, SENSE factor 2
SAG T1 SE Scan time 2:45 min. <br> 
TR 640 ms, TE 18 ms<br> 
FOV 240 x 240 x 145 mm <br> 
Voxel size 0.47 x 0.47 x 5.0 mm <br> 
21 slices<br>FLAIR_longTR Scan time 2:45 min. <br> 
TR 11000 ms, TE 140 ms, TI 2800 ms <br> 
FOV 230 x 197 x 149 mm <br> 
Voxel size 0.45 x 0.45 x 5.0 mm <br> 
24 slices, SENSE factor 1.5 <br>
SAG T1 SE
FLAIR_longTR
Scan time 2:45 min.
TR 640 ms, TE 18 ms
FOV 240 x 240 x 145 mm
Voxel size 0.47 x 0.47 x 5.0 mm
21 slices
Scan time 2:45 min.
TR 11000 ms, TE 140 ms, TI 2800 ms
FOV 230 x 197 x 149 mm
Voxel size 0.45 x 0.45 x 5.0 mm
24 slices, SENSE factor 1.5
sT1W_3D_TFE_AX Scan time 5:23 min. <br> 
TR 9.4 ms, TE 4.6 ms<br> 
FOV 230 x 197 x 143 mm <br> 
Voxel size 0.51 x 0.51 x 1.0 mm <br> 
170 slices, SENSE factor P 1.7, S 1.3<br>sT1W_3D_TFE_AXPOST Scan time 5:23 min. <br> 
TR 9.4 ms, TE 4.6 ms<br> 
FOV 230 x 197 x 143 mm <br> 
Voxel size 0.51 x 0.51 x 1.0 mm <br> 
170 slices, SENSE factor P 1.7, S 1.3<br>
sT1W_3D_TFE_AX
sT1W_3D_TFE_AXPOST
Scan time 5:23 min.
TR 9.4 ms, TE 4.6 ms
FOV 230 x 197 x 143 mm
Voxel size 0.51 x 0.51 x 1.0 mm
170 slices, SENSE factor P 1.7, S 1.3
Scan time 5:23 min.
TR 9.4 ms, TE 4.6 ms
FOV 230 x 197 x 143 mm
Voxel size 0.51 x 0.51 x 1.0 mm
170 slices, SENSE factor P 1.7, S 1.3

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.

For convenience and to reduce the risk of patient movement during contrast administration, an i.v. access with an extension is placed prior to the examination.

Postprocessing / analysis

SmartLine post-processing steps have been added to the DWI and sT1W_3D_TFE_AXPOST scans.

From the DWI, 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.

 

From the sT1W_3D_TFE_AXPOST, two multiplanar reformats are made in the VolumeView package:

  • SAG T1 TFE POST MPR        
  • COR T1 TFE POST MPR      

 

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

Postprocessed images

SAG T1 TFE POST MPR 45 slices<br>
Slice thickness 4mm<br>
Slice gap 0.0 mm<br>COR T1 TFE POST MPR 45 slices<br>
Slice thickness 4 mm<br>
Slice gap 0.0 mm<br>
SAG T1 TFE POST MPR
COR T1 TFE POST MPR
45 slices
Slice thickness 4mm
Slice gap 0.0 mm
45 slices
Slice thickness 4 mm
Slice gap 0.0 mm

Related reading



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

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