NetForum uses cookies to ensure that we give you the best experience on our website. If you continue to use the site, we'll assume that you are happy to receive these cookies on the NetForum website. Read about our cookies.
NetForum Community
Learn. Share. Optimize.
Log in | Sign up now | Submit content | Contact

Attention valued NetForum members:

Due to evolving technology needs and global privacy regulations, we have made the hard decision to suspend the NetForum User Community platform on Friday, November 29, 2019.

After this date, the current NetForum can no longer be reached. Please click here for more information about this decision, what happens next and how to stay in touch with us about the future of the community.

Go to similar content

Ingenia 1.5T C/T spine 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 for C-spine:

Download
Login is required to download ExamCards.

Download ExamCard for T-spine:

Download
Login is required to download ExamCards.

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).  

 

SJHMC uses mDIXON TSE extensively in spine imaging in the Emergency Department. It's particularly nice in that it is very robust with regards to susceptibility type of problems that would come up with traditional spectral fat-saturation images; this is a great advantage of the mDIXON technique.

 

 

These ExamCards are created on an Ingenia 1.5T system with Release 5.1.9.

   

The Cervical spine pre- and post-contrast ExamCard was created to be used for patients with:

  • AVM (arteriovenous malformation)
  • infection (discitis/osteomyelitis, epidural abcess)
  • Multiple Sclerosis
  • myelopathy/parasthesia
  • syrinx
  • tumor/mass/cancer/mets
  • vascular lesions
  •    

The Thoracic spine pre- and post-contrast ExamCard was created to be used for patients with:

  • AVM (arteriovenous malformation)
  • compression fracture (with hx malig/mets)
  • discitis/osteomyelitis
  • Multiple Sclerosis
  • myelopathy
  • syrinx
  • tumor/mass/cancer/mets
  • vascular lesions


In case of myelopathy a more traditional STIR exam is used instead of T2W mDIXON because of the slightly improved contrast within the cord. mDIXON is used for post-contrast T1-weighted imaging so that water-only and fat-plus-water post-contrast T1-weighted imaging is available.

 


In both ExamCards an alternative AX T2 TSE (METAL) scan of four minutes scan duration was added for use in patients post surgery.

 

View the full Neuro ED MRI ordering guide of SJHMC

ExamCard overview

ExamCard Cervical spine with contrast Total ExamCard scan time is 19:06 min.  without the optional C AX T2 TSE (METAL) scan.
SmartLine postprocessing steps are included for the T2W mDIXON and mFFE scans.ExamCard Thoracic spine with contrast Total ExamCard scan time is 20:36 min.
without the optional C AX T2 TSE (METAL) scan.
SmartLine postprocessing steps are included for the T2W mDIXON and mFFE scans.
ExamCard Cervical spine with contrast
ExamCard Thoracic spine with contrast
Total ExamCard scan time is 19:06 min. without the optional C AX T2 TSE (METAL) scan. SmartLine postprocessing steps are included for the T2W mDIXON and mFFE scans.
Total ExamCard scan time is 20:36 min. without the optional C AX T2 TSE (METAL) scan. SmartLine postprocessing steps are included for the T2W mDIXON and mFFE scans.

ExamCard images thoracic spine

T SAG STIR Scan time 4:04 min. <br> 
TR 2000 ms, TE 32 ms <br> 
TI 145ms <br> 
FOV  160 x 346 x 43 mm <br> 
Voxels 0.66 x 0.66 x 3.0 mm <br> 
13 slices, SENSE factor 1.0 <br>T SAG T1 Scan time 2:44 min. <br> 
TR 524 ms, TE 15 ms <br> 
FOV 160 x 34 5x 43 mm <br> 
Voxels 0.38 x 0.38 x 3.0 mm <br> 
13 slices, SENSE factor 1.50 <br>
T SAG STIR
T SAG T1
Scan time 4:04 min.
TR 2000 ms, TE 32 ms
TI 145ms
FOV 160 x 346 x 43 mm
Voxels 0.66 x 0.66 x 3.0 mm
13 slices, SENSE factor 1.0
Scan time 2:44 min.
TR 524 ms, TE 15 ms
FOV 160 x 34 5x 43 mm
Voxels 0.38 x 0.38 x 3.0 mm
13 slices, SENSE factor 1.50
T AX mFFE (no metal) Scan time 5:39 min. <br> 
TR 600 ms, TE1 6.8 ms, delta TE 2.8 ms <br> 
FOV  150 x 150 x 369 mm <br> 
Voxels 0.29 x 0.29 x 5.0 mm <br> 
53 slices, SENSE factor 1.0 <br>T AX T1 TSE post contrast Scan time 3:56 min. <br> 
TR 606 ms, TE 8.0 ms <br> 
FOV 150 x 150 x 369 mm <br> 
Voxels 0.29 x 0.29 x 5.0 mm <br> 
53 slices, SENSE factor 1.0 <br>
T AX mFFE (no metal)
T AX T1 TSE post contrast
Scan time 5:39 min.
TR 600 ms, TE1 6.8 ms, delta TE 2.8 ms
FOV 150 x 150 x 369 mm
Voxels 0.29 x 0.29 x 5.0 mm
53 slices, SENSE factor 1.0
Scan time 3:56 min.
TR 606 ms, TE 8.0 ms
FOV 150 x 150 x 369 mm
Voxels 0.29 x 0.29 x 5.0 mm
53 slices, SENSE factor 1.0
T SAG T1 mDIXON in-phase, post contrast Scan time 2:44 min. <br> 
TR 524 ms, TE 15 ms <br> 
FOV 160 x 344 x 43 mm <br> 
Voxels 0.38 x 0.38 x 3.0 mm <br> 
13 slices, SENSE factor 1.5 <br>T SAG T1 mDIXON water only, post-contrast Scan time 2:44 min. <br> 
TR 524 ms, TE 15 ms <br> 
FOV 160 x 344 x 43 mm <br> 
Voxels 0.38 x 0.38 x 3.0 mm <br> 
13 slices, SENSE factor 1.5 <br>
T SAG T1 mDIXON in-phase, post contrast
T SAG T1 mDIXON water only, post-contrast
Scan time 2:44 min.
TR 524 ms, TE 15 ms
FOV 160 x 344 x 43 mm
Voxels 0.38 x 0.38 x 3.0 mm
13 slices, SENSE factor 1.5
Scan time 2:44 min.
TR 524 ms, TE 15 ms
FOV 160 x 344 x 43 mm
Voxels 0.38 x 0.38 x 3.0 mm
13 slices, SENSE factor 1.5

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.

To increase the signal in the scans, it is recommended to position a dS Torso coil on the chest of the patient.

Contrast agent

Refer to the contrast agent manufacturer for information on dose and indications for use.

 

 

A manual start has been added to each of the ExamCards at the position of the 'SAG T1 mDIXON' scans, to indicate that the contrast agent should be injected prior to starting the scan.

Postprocessing / analysis

SmartLine postprocessing steps, ImageAlgebra, have been added to the

  • T2W_mDIXON_TSE scan to reconstruct a seperate image series of the fat images and of the water images. This enables easier viewing of the data on peripheral workstations and PACS systems.
  • mFFE (NO METAL) scan to cumulate the multiple FFE echoes into one image series.

 

 

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

Related reading



This content has been made possible by NetForum Community.
Share this on: Share your link in twitter Share your link in facebook Share your link on LinkedIn Print Rate this article: Log in to vote

 
Rating:
Votes:
1
Views:
823
Added:
Oct 31, 2017

Rate this:
Log in to vote
 

ExamCard
Ingenia 1.5T
Release 5
Cervical spine, dStream, Emergency Department, mDIXON, mDIXON TSE, mFFE, Neuro, Spine, Thoracic spine
 

Clinical News
Best Practices
Case Studies
Publications and Abstracts
White Papers
Web seminars and Presentations
ExamCards
Protocols
Application Tips and FAQ
Training
Try an Application
Business News
Case Studies
White Papers
Web Seminars and Presentations
Utilization Services
Contributing Professionals
Contributing Institutions
Become a Contributor