MRI Protocol

	B	C	D	E	F	G
1	Liver MRI with contrast
2	Indications:	liver lesion characterization; metastatic disease workup; screening for HCC in chronic liver diseases
3	Contrast	type		rate	volume	saline flush
4		Multihance
5	Acquisition	sequence	fat sat	comments
6	Cor/Ax	T2 HASTE/SSFSE	N
7	Ax	T2 TSE/FSE	Y	Resp. triggered, BLADE/PROPELLER. If cannot acquire good result run FS AX HASTE/SSFSE.
8	Ax	T1 GRE IN/OPP	n/a
9	Ax	DWI	n/a
10	Ax	T1 VIBE/LAVA pre-Gd	Y	pre-contrast
11	Ax	T1 VIBE/LAVA post-Gd	Y	care bolus arterial phase: breath hold and start scan immediately after Gd reaches heart
12	Ax	T1 VIBE/LAVA post-Gd	Y	portal phase: begin 10 sec after arterial phase complete (70 sec)
13	Ax	T1 VIBE/LAVA post-Gd	Y	equilibrium phase: start 3-5 min after contrast injection.
14	Cor	T1 VIBE/LAVA post-Gd	Y	wait 15-20 sec to recover breath, then run
15	Ax	T1 VIBE/LAVA post-Gd	Y	wait additional 5 min: ONLY RUN if indication includes hemangioma or cholangiocarcinoma (otherwise equilibrium is last sequence)
16	Comments:	care bolus: coronal fast gradient refocused sequence to trigger arterial phase at the moment contrast reaches the heart. Patient must hold breath at this moment and arterial phase run immediately.
17	Liver MRI without contrast
18	Indications:	liver lesion characterization; metastatic disease workup; screening for HCC in chronic liver diseases
19	Comments:	contrast strongly preferred - if non-contrast study ordered, indication should be reviewed by radiologist
20	Acquisition	sequence	fat sat	comments
21	Cor/Ax	T2 HASTE/SSFSE	N
22	Ax	T2 TSE/FSE	Y	Resp. triggered, BLADE/PROPELLER. If cannot acquire good result run FS AX HASTE.
23	Ax	T1 GRE IN/OPP	n/a
24	Ax	DWI	n/a
25	Ax	T1 VIBE/LAVA	Y
26	Cor	T1 VIBE/LAVA	Y
27	Comments:
28	Liver MRI with Eovist
29	Indications:	suspect FNH (focal nodular hyperplasia); metastatic workup; cirrhosis screening; biliary reconstruction, bile leak
30	Comments:	Eovist will be specifically requested. If unsure call radiologist.
31	Contrast	type		rate	volume	saline flush
32		Eovist
33	Acquisition	sequence	fat sat	comments
34	Cor/Ax	T2 HASTE/SSFSE	N
35	Ax	T1 GRE IN/OPP	n/a
36	Ax	T1 VIBE/LAVA pre-Gd	Y	pre-contrast
37	Ax	T1 VIBE/LAVA post-Gd	Y	care bolus arterial phase: breath hold and start scan immediately after Gd reaches heart
38	Ax	T1 VIBE/LAVA post-Gd	Y	portal phase: begin 10 sec after arterial phase complete
39	Ax	DWI	n/a
40	Ax	T1 VIBE/LAVA post-Gd	Y	equilibrium phase: start 5 min after portal phase complete.
41	Ax	T2 TSE/FSE	Y	resp. triggered, BLADE/PROPELLER. If cannot acquire good result run FS AX HASTE/SSFSE.
42	Ax	T1 VIBE/LAVA post-Gd	Y	total 20 min. delay after contrast injection
43	Cor	T1 VIBE/LAVA post-Gd	Y
44	Comments:	care bolus
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