DHMC Body MRI Protocol Book

Last Updated 7/3/2024

©2024 Dartmouth-Hitchcock Medical Center

The contents of DHMC’s Body MRI Protocol Book may not be reproduced without permission, but we are usually able – and happy – to extend such
permission.

1
 Key Points on Using this Protocol Book

• This protocol book was built using Siemens as the main brand of machine in mind.
• The parameters listed in this book are required parameters from the radiologist. Other
parameters such as matrix size, averages, and acceleration are unique and will not work the
same on every brand (GE, Siemens, Philips) or strength (1.5T, 3T) of machine. It is
recommended that you start with a stock sequence and adjust from this point.

2
 BODY MRI PROTOCOLS INDEX

Abdomen Pelvis
Adrenal Pancreas Anal Fistula Gyn Onc BT Plan
Basic Abdomen Renal Mass Appendicitis Pregnant Ovarian/Adnexal Mass
Dynamic Liver Urogram Basic Pelvis Penile
Elastography Cervical CA Staging Rectal Cancer
Enterography Defogram Routine Female Pelvis
Eovist Liver Dynamic (Multiparametric) Prostate RT Prostate
Liver for Hemochromatosis Endometrial Cancer
MRCP Female Pelvis Mullerian
Pancreas / MRCP Female Pelvis -Urethral
MRA/MRV Other
Aorta (CAP) MRA MRA Popliteal Entrapment Body AVM MRV Pelvis DVT
Mesenteric MRA Renal MRA

3
Adrenal

Coronal T2: diaphragm to aortic bifurcation

Axial IN/OUT PHASE Adrenals
Coronal IN/OUT PHASE Adrenals
Axial T2 FS: diaphragm to aortic bifurcation
Axial VIBE FS Pre: diaphragm to aortic bifurcation
Axial VIBE FS Post: diaphragm to aortic bifurcation ***Subtractions***
(35 SEC/70 SEC)
Coronal VIBE FS Post
(3 MIN)

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
COR T2 1600 91 440 100 5 1 R/L P->A
1.2/2.4 (3T)
AX IN/OUT PHASE 170 2.2/4.4(1.5T) 380 75 4 1 A/P S->I

1.2/2.4 (3T)
COR IN/OUT
170 2.2/4.4(1.5T) 380 75 4 1 A/P S->I
PHASE

AX T2 FS 1600 95 380 75 5 1 A/P S->I

AX VIBE FS PRE 4.3 1.8 380 80 3 0.6 A/P S->I

AX VIBE FS POST 4.3 1.8 380 80 3 0.6 A/P S->I
COR VIBE FS POST 4 1.7 400 100 3 0.6 R/L P->A

4
Basic Abdomen
(Cancer surveillance, non-specific clinical history)

Coronal T2 Abdomen
Axial In/Out Phase Abdomen
Axial T2 FS Abdomen
Axial DWI Abdomen
Axial VIBE FS Pre Abdomen
Axial VIBE FS Post Abdomen (60-70sec) ***Subtractions***
Coronal VIBE FS Post Abdomen

FOV PHASE SCAN

Sequence TR TE SLICE GAP OTHER
FREQ PHASE DIR DIR
COR T2 ABD 1400 91 440 100% 5 1 R/L P->A
1.2
AX IN/OUT PHASE ABD 170 and 380 80% 5 1 A/P S->I
2.4
AX T2 FS ABD 1600 95 380 80% 5 1 A/P S->I
B VALUE:
AX DWI ABD 5800 61 380 80 5 1 A/P S->I
50/400/750
AX VIBE FS PRE ABD 4.3 1.89 380 80% 3 0.6 A/P S->I
AX VIBE FS POST ABD
4.3 1.89 380 80% 3 0.6 A/P S->I
(60-70 SEC)
COR VIBE FS POST ABD 4.3 1.89 440 100% 3 0.6 R/L P->A

5
Dynamic Liver
(HCC, Cholangiocarcinoma, lesion characterization, Hypervascular metastases)
Coronal T2
Axial T2
Axial T2 FS
Axial IN/OUT PHASE
Axial VIBE FS Pre
Axial VIBE FS Post ***Subtractions***
(30 SEC/1 MIN/3 MIN/5 MIN)
Coronal VIBE FS Post
(4 MIN)
Axial DIFFUSION (b value 50, 400, and 750)
Need ADC maps

FOV Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
COR T2 1600 91 440 100 5 1 R/L P->A
AX T2 1600 95 380 75 5 1 A/P S->I
AX T2 FS 1600 95 380 75 5 1 A/P S->I
1.2/2.4 (3T)
AX IN/OUT
170 2.2/4.4(1.5T) 380 75 5 1 A/P S->I
PHASE

AX VIBE FS PRE 4.3 1.8 380 80 3 0.6 A/P S->I

AX VIBE FS
4.3 1.8 380 80 3 0.6 A/P S->I
POST
COR VIBE FS
4 1.7 400 100 3 0.6 R/L P->A
POST
B VALUE:
AX DIFFUSION 5800 61 380 80 5 1 A/P S->I
50/400/750
6
Elastography

Resoundant System Setup (Outback by MR 1 Cabinets on Table):

- If system is off, turn on
- If system is on, shut off and turn back on
- On hospital computer, pull up IP address of the system in web browser (bottom of monitor)
- Choose correct profile depending on patients wait (this will change the amplitude)
- Once patient is setup and in machine, hit the trigger option once on the Resoundant Screen. This will bump the patient
in the side. Make sure that it was felt and then you are ready to proceed with exam.

Patient:
- Device must be placed against the side of the patient
- For centering in the S-I Direction, find the xyphoid tip and center of the paddle should be at this level affixed to the side
of the patient using the black Velcro strap
- Tips for placement, when strapping paddle to patient, must be tight. If patient is slightly uncomfortable then the strap
is placed correctly.

7
1.5T ONLY – DHMC Siemens Sola ONLY
Full abdomen/liver/spleen coverage:
Coronal T2
Axial IN/OUT PHASE
4 slices through the liver:
Axial MRE (EPI, 4 Slices)
***IF IRON IN LIVER***
Axial MRE (EPI, FRACT, 4 Slices)

***AMPLITUDE ON RESOUNDANT SYSTEM AND ON THE SCANNER (ELASTOGRAPHY TAB) MUST MATCH***

***Make sure slice placement is not in the heart anatomy***

FOV PHASE SCAN

Sequence TR TE SLICE GAP OTHER
FREQ PHASE DIR DIR
COR T2 1600 91 440 100% 5 1 R/L P->A
Whole Liver
1.2/2.4 (3T)
AX IN/OUT PHASE 170 380 75 5 1 A/P S->I Coverage
2.2/4.4(1.5T)
MRE SEQUENCE
AX MRE (EPI, 4 Slices) 1200 47 420 100 8 2 A/P S->I
MRE SEQUENCE FOR IRON IN LIVER
AX MRE (EPI, 4 Slices) 1200 34 420 100 8 2 A/P S->I

8
Enterography
Patient prep: BREEZA, 3 bottles, 90 minutes prior
Glucagon – 0.5 mg IM after CISS
Coronal T2 CISS
*CHECKED BY RADIOLOGIST (SEE NOTE)*
*Have RN inject glucagon
Coronal T2 BH
Axial T2 BH (Combine/Stitch if applicable)
Axial T2 FS BH (Combine/Stitch if applicable)
Axial VIBE FS Pre
Coronal VIBE FS Pre
Coronal VIBE FS Post (35 SEC/ 70 SEC)
***Subtractions***
Axial VIBE FS Post ***Subtractions***

***IF UNABLE TO READ MD AFTER 5 MINUTES, PROCEED WITH EXAM AND DOCUMENT***
FOV PHASE SCAN
Sequence TR TE SLICE GAP OTHER
FREQ PHASE DIR DIR
COR T2 CISS 186 1.15 430 100 5.5 0 R->L P->A
***CHECK FOR GLUCAGON***
COR T2 1600 91 440 100 5 1 R/L P->A
AX T2 1600 95 380 75 5 1 A/P S->I
AX T2 FS 1600 95 380 75 5 1 A/P S->I
AX VIBE FS PRE 4.3 1.8 380 80 3 0.6 A/P S->I
COR VIBE FS PRE 4 1.7 440 100 3 0.6 R/L P->A
COR VIBE FS POST
4 1.7 440 100 3 0.6 R/L P->A
(35 and 70 sec)
AX VIBE FS Post 4.3 1.8 380 80 3 0.6 A/P S->I

9
Eovist Liver
(Differentiate FNH/adenoma, strongly consider for female with lesion, Hypovascular liver mets,
biliary leaks)
Coronal T2
Axial IN/OUT PHASE
Axial VIBE FS Pre
Axial VIBE FS Post ***Subtractions***
(2 phase arterial/1 MIN/3 MIN)
Coronal VIBE FS Post (4 MIN)
Axial VIBE FS Post (5 MIN)
Axial DIFFUSION Post (b value 50, 400, and 750) ***Need ADC Maps***
Axial T2 Post
Axial T2 FS Post
Axial VIBE FS Post (20 MIN)
Coronal VIBE FS Post (20 MIN) ***INCLUDE SUBTRACTIONS***
FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
COR T2 1600 91 440 100 5 1 R/L P->A
1.2/2.4 (3T)
AX IN/OUT
170 2.2/4.4(1.5T) 380 75 5 1 A/P S->I
PHASE

AX VIBE FS PRE 4.3 1.8 380 80 3 0.6 A/P S->I

AX VIBE FS
4.3 1.8 380 80 3 0.6 A/P S->I
POST
AX T2 Post 1600 95 380 75 5 1 A/P S->I
AX T2 FS Post 1600 95 380 75 5 1 A/P S->I
COR VIBE FS
4 1.7 400 100 3 0.6 R/L P->A
POST
B VALUE:
AX DIFFUSION 5800 61 380 80 5 1 A/P S->I
50/400/750

10
Liver for Hemochromatosis

1.5T ONLY – DHMC Siemens Sola or Aera’s ONLY

Full abdomen/liver/spleen coverage:
Coronal T2
Axial T2
Axial IN/OUT PHASE
3-5 slices through the liver and spleen:
Axial Multi TE GRE

Coverage for Multi TE GRE: Limited Coverage: 3-5

slices through liver and spleen

FOV PHASE SCAN

Sequence TR TE SLICE GAP OTHER
FREQ PHASE DIR DIR
COR T2 1600 91 440 100% 5 1 R/L P->A Whole Liver
AX T2 1600 95 380 75% 5 1 A/P S->I Coverage
1.2/2.4 (3T)
AX IN/OUT PHASE 170 380 75 5 1 A/P S->I
2.2/4.4(1.5T)
Limited
*Multi TE Coverage – 3-5
AX Multi TE GRE 120 380 85% 10 2 A/P S->I slices through
Values
liver and spleen

11
MRCP
Patient prep: NPO 4 hours prior. Arrive 20-30 min early for 6 oz’s of PO pineapple juice
Coronal T2
Axial T2
Thick Slab SSFSE – 3 Oblique planes through pancreas/CBD/GB 40mm Thick
Coronal 3D Volume Respiratory Triggered MRCP *
1. Thin Coronal MIP images created at 1.6/0.8
2. Thin Axial MIP images created at 1.6/0.8
*Do breath hold Coronal 3D acquisition if the respiratory triggered is poor
IF SECRETIN EXAM:
*SECRETIN: ADULT: 0.2µg/kg IV slowly pushed over 1 minute
PEDIATRIC: 0.2µg/kg (MAX DOSE 16 µg)
*ADMINISTERED BY ANGIO RN – IV PUSH
THICK SLAB SSFSE THROUGH PLANE OF PANCREATIC DUCT EVERY MINUTE FOR 10 MINUTES (STACKED)

THICK SLAB ANGLES

THICK SLAB:
Coronal and Coronal Oblique x2 Axial Coverage

12
MRCP continued

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm)
(mm) Direction Direction
%
COR T2 1600 91 440 100 5 1 R/L P->A
AX T2 1600 95 380 75 5 1 A/P S->I
COR THICK
4500 735 300 100 50 25 L/R P->A
SLAB
COR OBLIQ
4500 735 300 100 50 25 L/R P->A
SLAB 1
COR OBLIQ
4500 735 300 100 50 25 L/R P->A
SLAB 2
COR 3D RESP
5800 698 380 100 1 0 R/L P->A
TRIGGERED
COR 3D
2000 697 380 100 1 .5 R/L P->A
BREATH HOLD
***IF SECRETIN USED***
COR THK SLAB
4500 735 300 100 50 25 P/A P->A RUN X 10
POST SECRETIN

13
Pancreas / MRCP

Patient prep: NPO 4 hours prior. Arrive 20-30 min early for 6oz’s of PO pineapple juice
Coronal T2 FS
Axial T2
Axial T2 FS Thin Pancreas ONLY
Axial IN/OUT PHASE
Thick Slab SSFSE – 3 Oblique planes through pancreas/CBD/GB 40mm Thick
Coronal 3D Volume Respiratory Triggered MRCP *
1. Thin Coronal MIP images created at 1.6/0.8
2. Thin Axial MIP images created at 1.6/0.8
*Do breath hold Coronal 3D acquisition if the respiratory triggered is poor
Axial VIBE FS Pre
Axial VIBE FS Post (35 SEC/70 SEC/3 MIN) ***Subtractions***
Coronal VIBE FS Post (3 MIN)

THICK SLAB:
Axial Coverage
Coronal and Coronal Oblique x2

14
Pancreas / MRCP Continued

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm)
(mm) Direction Direction
%
COR T2 FS 1600 91 440 100 5 1 R/L P->A

AXIAL T2 1600 95 380 75 5 1 A/P S->I

Pancreas
AX T2 FS Thin 1600 95 380 75 3 1 A/P S->I
Only
1.2/2.4 (3T)
AX IN/OUT
170 2.2/4.4(1.5T) 380 75 5 1 A/P S->I
PHASE

AX VIBE FS PRE 4.3 1.8 380 80 3 0.6 A/P S->I

COR THICK
4500 735 300 100 50 25 L/R P->A
SLAB
COR OBLIQ
4500 735 300 100 50 25 L/R P->A
SLAB 1
COR OBLIQ
4500 735 300 100 50 25 L/R P->A
SLAB 2
COR 3D RESP
5800 698 380 100 1 0 R/L P->A
TRIGGERED
COR 3D
2000 697 380 100 1 .5 R/L P->A
BREATH HOLD
AX VIBE FS
4.3 1.8 380 80 3 0.6 A/P S->I
POST
COR VIBE FS
4 1.7 400 100 3 0.6 R/L P->A
POST

15
Pancreas
(Tumors, staging, follow up cystic lesions, Pancreatitis)
Patient Prep: NPO for 4 hours, If MRCP NOT requested, 24oz’s of water (PO) 30 min. prior
Coronal T2 FS
Axial T2
Coronal T2 Thin Pancreas ONLY
Axial T2 FS Thin Pancreas ONLY
Axial IN/OUT PHASE
Axial VIBE FS Pre
Axial VIBE FS Post (35 SEC/70 SEC/3 MIN) ***Subtractions***
Coronal VIBE FS Post (3 MIN)

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm)
(mm) Direction Direction
%
COR T2 FS 1600 91 440 100 5 1 R/L P->A

AX T2 1600 95 380 75 5 1 A/P S->I

COR T2 Thin 1600 91 440 100 3 1 R/L P->A Pancreas

ONLY
AX T2 FS Thin 1600 95 380 75 3 1 A/P S->I
1.2/2.4 (3T)
AX IN/OUT
170 2.2/4.4(1.5T) 380 75 5 1 A/P S->I
PHASE

AX VIBE FS PRE 4.3 1.8 380 80 3 0.6 A/P S->I

AX VIBE FS
4.3 1.8 380 80 3 0.6 A/P S->I
POST
COR VIBE FS
4 1.7 400 100 3 0.6 R/L P->A
POST

16
Renal Mass
FOV limited to kidneys
Coronal T2
Axial T2
Axial T2 FS
Axial IN/OUT PHASE
Axial VIBE FS Pre
Coronal VIBE FS Pre
Coronal VIBE FS Post ***Subtractions***
(25 SEC/90 SEC/3 MIN) *with subtractions
Axial VIBE FS MIN Post ***Subtractions***
Axial DIFFUSION (b value of 50 and 800) and ADC maps

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
COR T2 1600 91 440 100 5 1 R/L P->A
AXIAL T2 1600 95 380 75 5 1 A/P S->I
AXIAL T2 FS 1600 95 380 75 5 1 A/P S->I
AXIAL IN/OUT 1.2/2.4 (3T)
170 380 75 5 1 A/P S->I
PHASE 2.2/4.4(1.5T)
AXIAL VIBE FS PRE 4.3 1.8 380 80 3 0.6 A/P S->I

COR VIBE FS PRE 4.3 1.8 380 80 3 0.6 A/P S->I

COR VIBE FS POST 4.3 1.8 380 80 3 0.6 R/L P->A
AX VIBE FS POST 4 1.7 400 100 3 0.6 A/P S->I
B VALUE:
AXIAL DIFFUSION 5800 61 380 80 5 1 A/P S->I
50/800

17
Urogram
Patient Prep: Arrive 1 hour prior to get IVF
Empty bladder prior to getting on table
Adult: 500mL NS bolus immediately before scan
Pediatric: weight based IVF:
4mL/kg/hr. 1st 10kg
2mL/kg/hr. next 10kg
1mL/kg/hr. for each kg above 20kg
Blood Pressure needs to be taken and document in EPIC before and after Lasix Injection
Adults: arrive 1 hour prior to angio for IV placement, fluids, possible catheter placement (optional)
*Lasix dose: 20-40mg slow IV push
Pediatrics: Requires Pain Free and catheter (can administer Lasix)
*Lasix dose: 1mg/kg (up to max dose 20mg) slow IV push
Coronal T2 Abdomen/Pelvis
Axial T2 Abdomen/Pelvis
Axial T2 FS Abdomen/Pelvis
Sagittal T2 FS Abdomen/Pelvis
**Inject Lasix**
Coronal T2 Thick Slab (straight coronal)
Coronal T2 Thin (1mm) Respiratory Triggered Kidneys/Ureters
Axial VIBE FS Pre-Abdomen/Pelvis
Coronal VIBE FS Pre
Coronal VIBE FS Post ***Subtractions***
- Coronal oblique plane to include kidneys and bladder (2mm slice thickness)
- Arterial (~30 sec), 100 SEC (nephrographic), 8 MIN (excretory)
- Automatic MIP images of each volume acquired
Axial VIBE FS Post ***Subtractions***
- 6 MIN (Between 100 SEC and 8 MIN Coronal Vibes)
Sagittal VIBE FS Post 10 MIN (need to see ureters to bladder)
18
Urogram continued

FOV: Slice
Gap Phase Scan
Sequence TR TE Thickness OTHER
Frequency Phase % (mm) Direction Direction
(mm)
COR T2 1600 91 440 100 5 1 R/L P->A

AXIAL T1 FS 572 20 380 75 5 1 A/P S->I

AXIAL T2 1600 95 380 75 5 1 A/P S->I
AXIAL T2 FS 1600 95 380 75 5 1 A/P S->I
SAGITTAL T2 FS 1600 95 380 75 5 1 A/P L->R
420 Straight
COR T2 THK Slabs 4500 564 80 50 0 R/L P->A
Coronal
COR T2 Thin
2400 698 380 100 1.0 R/L P->A
RESP TRIG
AXIAL VIBE FS PRE 1.8
4.3 380 80 3 0.6 A/P S->I
Post
COR VIBE FS PRE
30 SEC (Arterial),
100 SEC
4.3 1.8 400 80 2 0.4 R/L P->A
(Nephrographic),
8 MIN
(Excretory)
SAG VIBE FS POST 4.3 1.8 400 80 2 0.4 R/L P->A

19
Anal Fistula (3T ONLY)
Sagittal T2 (Full FOV, 2.5mm/gap 0mm)
CORONALS
*Use to establish oblique planes –
Axial and coronal to long axis of anal canal
*MD to check planes if unsure*
Small FOV (26cm):
Axial Oblique T1 (4mm/0.8)
Axial Oblique T2 FS (4mm/0.8)
Axial Oblique T2 (4mm/0.8)
Axial DWI Resolve OBL (B-Values 100, 500, 800), ADC Maps
Coronal Oblique T2 FS (4mm/0.8)
Coronal Oblique T2 (4mm/0.8) AXIALS
Axial Oblique VIBE FS Pre
Axial Oblique VIBE FS Post ***Subtractions***
Coronal Oblique VIBE FS Post
FOV: Slice
Gap Phase Scan
Sequence TR TE Thickness OTHER
Frequency Phase % (mm) Direction Direction
(mm)
SAG T2 2570 92 300 100 2.5 0 S/I L->R

AXIAL OBL T1 527 20 260 100 4 0.8 R/L S->I

AXIAL OBL T2 FS 3000 86 260 100 4 0.8 R/L S->I Coverage

AXIAL OBL T2 3000 86 260 100 4 0.8 R/L S->I
should
include the
AX DWI-RESOLVE OBL 8500 99 300 100 3 0 A/P S->I
entire anal
86 canal
COR OBL T2 FS 3000 260 100 4 0.8 R/L P->A
86 through the
COR OBL T2 3000 260 100 4 0.8 R/L P->A
soft tissue of
AX VIBE FS PRE 7.4 3.8 260 80 3 0.6 A/P S->I the buttocks
AX VIBE FS POST 7.4 3.8 260 80 3 0.6 A/P S->I

COR VIBE FS POST 7.2 3.8 260 100 3 0.6 R/L P->A

20
Appendicitis Pregnant
(R/O APPENDICITIS)
Coronal T2 SSFSE
Axial T2 SSFSE
Sagittal T2 SSFSE
Coronal T2 FS BH
Axial T2 FS BH
Coronal CISS
Axial CISS (Optional if questioning a kidney stone)

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
COR T2 SSFSE 1600 132 440 100 3 0.3 R/L P->A

AX T2 SSFSE 1600 132 380 75 3 0.3 A/P S->I

SAG T2 SSFSE 1600 132 440 100 6 1 A/P L->R
COR T2 FS BH 1600 132 380 194 3 0.3 R/L P->A

AX T2 FS 1600 135 380 75 3 0.3 A/P S->I

COR CISS 191 1.18 400 100 8 2 R/L P->A
AX CISS 191 1.18 400 100 8 2 A/P S->I

21
Basic Pelvis
(Cancer surveillance, non-specific clinical history)

Coronal T2 Pelvis
Axial DWI Pelvis
Axial Stir Pelvis
Axial VIBE FS Pre Pelvis
Axial VIBE FS Post Pelvis ***Subtractions***
Coronal VIBE FS Post Pelvis

FOV PHASE SCAN

Sequence TR TE SLICE GAP OTHER
FREQ PHASE DIR DIR
COR T2 PELVIS 1400 91 440 100% 5 1 R/L P->A
B VALUE:
AXIAL DWI PELVIS 5800 61 380 80 5 1 A/P S->I
50/400/750
AX STIR PELVIS 3500 95 380 80% 5 1 A/P S->I
AX VIBE FS Pre PELVIS 4.3 1.89 380 80% 3 0.6 A/P S->I
AX VIBE FS POST PELVIS 4.3 1.89 380 80% 3 0.6 A/P S->I
COR VIBE FS POST PEL 4.3 1.89 440 100% 3 0.6 R/L P->A

22
Cervical Cancer Staging (3T Preferred)
Please have patient evacuate bladder and rectum immediately prior to starting MRI
AXIALS
Please call body radiologist for selection of planes for small FOV axial images in
relation to the cervix UNLESS they have had priors, then copy angles from previous exam
Coronal T2 SSFSE (Pelvis)
Sagittal T2 (acetabulum to acetabulum)
Axial Oblique T2
Axial Oblique DWI Resolve
Axial T1 (Large FOV – top of L5 through perineum) CORONALS
Sagittal VIBE Pre (acetabulum to acetabulum)
***IF CONTRAST***
Axial VIBE Pre
Axial VIBE Post ***Subtractions*** Dashed white line parallel to the long axis of the cervix on
sagittal image. Solid white lines are the axial oblique scan
Sagittal VIBE Post
plane, perpendicular to the long axis of the cervix.
***Optional*** Axial T2 FS (Large FOV – top of L5 through perineum)
FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
Coronal T2 1400 91 400 100 6 1 R/L P->A Pelvis
Sag T2 5000 91 200 100 4 1 S/I L->R
Ax Oblique 5000 91 200 100 3 0.5 A/P S->I
91 b values 100,
Ax Obl. Resolve 8500 200 100 3 0.5 A/P S->I 500, and 800
Ax T1 500 11 320 100 5 1 R/L S->I
Sag VIBE
4.51 2.19 280 100 4 0.2 S/I L->R
Pre/Post
Ax VIBE
4.51 2.19 280 100 4 0.2 R/L S->I
Pre/Post
*Optional
3000 90 320 100 4 0.5 R/L S->I
Ax T2 FS

23
Defogram

Ax T2 Small FOV
Parallel to the line formed from the
Anorectal angle to the symphysis
Insert rectal gel:
Axial T2
Sagittal T2 to obtain midline
Sagittal CISS at Rest
Sagittal CISS with Kegel
Sagittal CISS with moderate straining
Sagittal CISS with defecation x 3 attempts SAG CISS FOV AX T2 Small FOV

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
Scanned
prior to
Ax T2 SM FOV 3100 91 200 100 3 0 A/P S->I
insertion of
rectal gel
AX T2 1600 95 380 75 5 1 A/P S->I With gel
SAG T2 1400 91 360 100 5 1 S/I L->R With gel
With gel
SAG CISS (X4) 3.89 1.7 306 100 7 1 S/I L->R 1 slice at
midline

24
Multiparametric Prostate
Elevated PSA, negative biopsy, staging cancer
Must be done on 3T/phased array body coil
Cover entire prostate and seminal vesicles

Axial T1 (Pelvis FOV, Aortic Bifurcation-Prostate)

Axial DWI Resolve OBL (B-Values 100, 500, 800), ADC Maps
Axial T2 OBL
Sagittal T2 AXIALS
Coronal T2 OBL
Axial Vibe Dynamic OBL Post (With Subtractions) CORONAL

Axial Vibe FS Post (Pelvis FOV)

Axial plain is perpendicular to anterior wall of rectum.
***Axials should cover through Seminal Vesicles Superiorly*** Coronal plain is parallel to anterior wall of rectum.

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
AX T1 650 10 300 100 5 1 R/L S->I Pelvis FOV
AX DWI-RESOLVE b values 100, 500,
8500 99 300 100 3 0 A/P S->I and 800
OBL
AX T2 OBL 3100 91 200 100 3 0 R/L S->I
SAG T2 3100 91 200 100 3 0 H/F L->R
COR T2 OBL 3100 91 220 100 3 0 R/L P->A
AX Vibe Dynamic 1.86
4.72 260 260 3 1 R/L S->I 20 Measurements
OBL Post
1.8
AX Vibe FS Post 4.3 380 80 3 0.6 A/P S->I Pelvis FOV

25
Endometrial Cancer
Planes for small FOV axial/coronal images in relation to the uterus

Large FOV:
Axial T1 Pelvis full FOV
Axial T2 FS Pelvis full FOV
Small FOV:
Sagittal T2 Small FOV
Axial OBL (SAX of the uterus) T2
Axial DWI Resolve OBL (B-Values 100, 500, 800), ADC Maps
Axial OBL (SAX of the uterus) VIBE FS Pre
Sagittal VIBE FS Pre
Sagittal VIBE FS Post (1 MIN/3 MIN/5 MIN) ***Subtractions***
Axial OBL (SAX) VIBE FS Post (4 MIN) ***Subtractions***

Axial Oblique - Short axis to the uterus

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
AX T1 4.30 1.89 380 81 3 A/P S->I Full Pelvis
AX T2 FS 3450 96 300 100 5 1 A/P S->I Full Pelvis
SAG T2 500 96 220 100 5 1 A/P L->R
AX OBL (SAX) T2 4900 96 200 100 5 1 R/L S->I
AX DWI-RESOLVE b values 100,
8500 99 300 100 3 0 A/P S->I 500, and 800
OBL
AX OBL (SAX)
4.3 2.08 240 100 3 0.6 R/L S->I
VIBE FS PRE
SAG VIBE FS PRE 4.51 2.19 240 81 3 0.6 A/P L->R
SAG VIBE FS POST 4.51 2.19 240 81 3 0.6 A/P L->R
AX OBL (SAX)
4.3 2.08 240 100 3 0.6 R/L S->I
VIBE FS PRE

26
Female Pelvis Mullerian
CALL RADIOLOGIST TO CHECK ANGLES FOR SCANNING

AXIALS
Axial T2 FS Full FOV
Axial T1 Full FOV
Coronal T2 Full FOV to include kidneys (7mm slice)
Sagittal T2 LG FOV (Pelvic Ring Side-Side) - Used for angle setup
Small FOV in relation to the UTERUS ONLY:
Sagittal T2 THN (2.5mm slice)
Axial T2 THN (2.5mm slice)
Coronal T2 THN (2.5mm slice)
CORONALS

FOV Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)

AX T2 FS 3450 96 300 100 5 1 A/P S->I Whole

AX T1 455 20 300 100 5 1 A/P S->I Pelvis
COR T2 1400 91 440 100 5 1 S/I P->A Full FOV
SAG T2 2800 101 250 100 4 1 S/I L->R LG FOV

SAG T2 THN 4960 220 100 2.5 .5 S/I L->R UTERUS ONLY
91
AX T2 THN 4960 91 200 100 2.5 .5 A/P S->I UTERUS ONLY

COR T2 THN 4960 91 200 100 2.5 .5 S/I P->A UTERUS ONLY

27
Female Pelvis - Urethral
Coronal T2 (wide FOV to include kidneys)
Small FOV (18cm-24cm) centered at urethra:
Axial T2 FS (Perpendicular to urethra)
Sagittal T2 FS AXIALS
Coronal T2 FS (Parallel to urethra)
Axial VIBE FS Pre
Axial VIBE FS Post ***Subtractions***
Sagittal VIBE FS Post CORONALS
Coronal VIBE FS Post

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
COR T2 1800 95 440 100 5 1 R/L P->A Full FOV
AXIAL T2 FS 3000 91 200 100 3 1 R/L S->I
SAG T2 FS 3000 86 220 100 3 1 A/P L->R

COR T2 FS 3000 86 220 100 3 1 R/L P->A

AXIAL VIBE FS PRE 4.8 2.19 240 100 3 A/P S->I

AXIAL VIBE FS
4.8 2.19 240 100 3 A/P S->I
POST
SAG VIBE FS POST 3.19 1.46 240 100 2 A/P L->R
COR VIBE FS POST 3.19 1.46 240 100 2 R/L P->A

28
Gyn Onc BT Plan (1.5T DHMC ONLY)

Please call body radiologist for selection of planes for small FOV axial images in
relation to the cervix UNLESS, patients has priors, then copy angles from previous exam
LARGE FOV to Include Kidneys
Coronal T2
PELVIS FOV (L4/L5 thru Vagina) AXIALS
Axial T1 Pelvis
Axial T1 Flair Pelvis
Axial T2 Pelvis
SMALL FOV Relative to Cervix
Sagittal T2
Axial Obl. T2
Axial plane is perpendicular to the implanted device, while
Coronal Obl. T2 the coronal plane is parallel.

FOV: Slice CORONALS

Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
2000- Include
COR T2 80-120 400 100 6 1 R/L P->A
6000 Kidneys
AX T1 400-600 10-30 400 100 6 1 A/P S->I Pelvis FOV
AX T1 Flair 1576 91 400 100 6 1 A/P S->I Pelvis FOV
2000- 80-120
AX T2 400 100 5 1 A/P S->I Pelvis FOV
6000
2000-
SAG T2 80-120 280 100 3 0.5 S/I L->R CERVIX FOV
6000
2000-
AX OBL T2 80-120 280 100 2.8 0.5 A/P S->I CERVIX FOV
6000
2000-
COR OBL T2 80-120 280 100 3 0.5 R/L P->A CERVIX FOV
6000
29
Ovarian Mass (Siemens ONLY)
Planes in relation to the pelvis unless otherwise specified.
Coronal T2
Sagittal T2
Axial T2 AXIALS
Axial DWI Resolve
Axial T1 Dixon
Axial Dynamic Post
Sag Vibe FS Post
Axial Vibe FS Post (Whole Pelvis)

FOV:
Slice Phase Scan Scan
Phase Gap Direction Direction Direction
Sequence TR TE Frequency
%
Thickness
(mm)
(mm)

COR T2 3100 91 220 100 3 0 R/L P->A

SAG T2 3100 91 200 100 3 0 H/F R->L
AX T2 3100 91 200 100 3 0 R/L S->I
DWI -RESOLVE 8500 99 300 100 3 0 A/P S->I
AX T1 DIXON 9.53 2.39 200 100 3 0 R/L S->I
Dynamic Ax Post 4.72 1.86 260 260 3 1 R/l S->I
SAG VIBE FS Post 4.51 2.19 240 81 3 0.6 H/F L->R
AX VIBE FS Post Whole
8.87 4.77 340 100 3 0.6 R/L S->I
(WHOLE PELVIS) Pelvis

30
Penile (3T ONLY)
Axial T1 Large FOV
Axial T2 Small FOV
Sagittal T2 Small FOV
Coronal T2 Small FOV
Axial T2 FS Small FOV
Axial T1 In/Out Phase
Axial DWI
Axial VIBE FS Pre
Patient positioning: Patient is imaged in a supine position. To elevate the scrotum and penis, a folded
Axial VIBE FS Post towel is placed between the patient’s legs. The penis is taped to the abdomen in a dorsi-flexed position
***Subtractions*** to prevent movement and pulsation artifacts. A surface coil is placed on the penis to improve signal-to-
Sagittal VIBE FS Post noise ratio. Small FOV Imaging planes are in axis with the penis.
FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness
(mm) Direction Direction OTHER
Frequency (mm)
%
LG FOV –
AX T1 400 11 340 100 5 1 A/P S->I Axial to the
body
AXIAL T2 3000 91 160 100 4 0.5 R/L S->I SM FOV
Angled to the
SAG T2 3000 86 160 100 4 0.5 A/P L->R axis of the
COR T2 3000 86 160 100 4 0.5 S/I P->A penis
(Interpolation
AX T2 FS 3000 91 160 100 4 0.5 R/L S->I or Zip512)
1.2/2.4 (3T)
Ax In/Out Phase 170
2.2/4.4(1.5T)
340 100 4 1 A/P S->I
Ax DWI 8500 95 340 100 8 2 A/P S->I LG FOV –
AXIAL VIBE FS Axial to the
4.8 2.19 260 100 3 0 A/P S->I
PRE body
AXIAL VIBE FS
4.8 2.19 260 100 3 0 A/P S->I
POST
SAG VIBE FS
3.19 1.46 260 100 3 0 A/P L->R
POST

31
Rectal Cancer (3T Preferred)
Should be performed on 3T. Must be done during the day to be monitored by a radiologist.
Planes for Small FOV axial/coronal image angles determined by radiologist, UNLESS, patients has priors, then copy angles from previous exam

Axial T2 (large FOV)

Sagittal FRFSE T2
Axial Oblique FRFSE T2 (short axis) – These are axial to the long axis of the tumor/rectum
Axial Oblique DWI (B=100, 500, 800)
Coronal Oblique T2 (long axis) – Parallel to the long axis of the rectum/tumor/anal canal as prescribed by the radiologist
who QC’s the case
Axial Oblique VIBE FS Pre (small FOV: 3mm slice)
Axial Oblique VIBE FS Post (small FOV: 3mm slice) ***Subtractions***
Coronal Oblique VIBE FS Post (small FOV: 3mm slice)
Sagittal Oblique VIBE FS Post (small FOV: 3mm slice)

32
 Tips for MRI technologist:

Call MD to help select the best imaging planes.

Axial Oblique imaging plane must be perpendicular to the long axis of the rectum at the level of the tumor.

High resolution axial oblique images may be repeated if anatomy is curved or the original acquisition does not cover correct anatomy.

If motion artifacts: try fat saturation band or swap phase and frequency.

Rectal Cancer Continued

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
Through the
Axial T2 2500 80 300 100 5 1 A/P S->I bifurcation
SAG T2 2800 101 250 100 4 1 S/I L->R
***RAD PLAN ANGLES, UNLESS PATIENT HAS HAD PRIORS, THEN COPY PREVIOUS EXAM***
0 GE: Zip512
1.5T: 160
Axial Obl T2 (SAX) 6100 88 100 3 GE 1.5T: A/P S->I Siemens:
3T: 200 0.3 Interpolation
Ax DWI b values 100,
5000 280 100 6 1 A/P S->I 500, and 800
Skyras: Resolve DWI Min
0 GE: Zip512
78 1.5T: 160
COR OBL T2 3000 100 3 GE 1.5T: R/L P->A Siemens:
3T: 200 0.3 Interpolation
2.65
AX OBL VIBE FS PRE 6.47 240 100 3 1 A/P S->I

AX OBL VIBE FS POST 6.47 2.65 240 100 3 1 A/P S->I

COR OBL VIBE FS
6.2 2.64 240 100 3 1 R/L P->A
POST
SAG OBL VIBE FS
6.2 2.64 240 100 3 1 A/P L->R
POST

33
Routine Female Pelvis
Adenomyosis, fibroids, adnexa
Planes in relation to the uterus for uterine pathology, otherwise in relation to pelvis
Coronal T2 Whole Pelvis
AXIALS
Axial T1 Whole Pelvis
Small FOV:
Axial T2
Axial T2 FS
Sagittal T2 (uterine evaluation)
Sagittal T2 FS
Axial VIBE FS Pre
***OPTIONAL WITH CONTRAST*** CORONALS
Axial VIBE FS Post ***Subtractions***
Coronal VIBE FS Post
Sagittal VIBE FS Post

FOV Slice
Gap Phase Scan
Sequence TR TE Thickness OTHER
Frequency Phase % (mm) Direction Direction
(mm)
COR T2 1400 91 440 100 5 1 R/L P->A Whole Pelvis

AX T1 455 20 300 100 5 1 R/L S->I Whole Pelvis

AX T2 5370 91 200 100 5 1 R/L S->I

AX T2 FS 3000 91 200 100 5 1 R/L S->I

SAG T2 5160 91 220 100 5 1 S/I L->R

SAG T2 FS 3000 91 220 100 5 1 S/I L->R
AX VIBE FS Pre 6.47 2.65 240 100 3 1 A/P S->I
AX VIBE FS Post 6.47 2.65 240 100 3 1 A/P S->I
COR VIBE FS Post 4.42 1.46 240 109.4 2 1 R/L P->A
Sag VIBE FS Post 4.42 1.46 240 100 2 1 A/P L->R

34
RT Prostate G-
Performed for radiation planning purposes
Set angles straight to the pelvis and cover prostate and seminal vesicles

Axial T1 whole pelvis

Small FOV:
Axial T1
Axial T2 (3mm slice)
Sagittal T2 (3mm slice)
Coronal T2 (3mm slice)
Axial 3D T2

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
AX T1 455 20 300 100 5 1 R/L S->I Pelvis
AX T1 626 13 200 100 5 1 R/L S->I
AX T2 3000 91 200 100 3 0 R/L S->I
SAG T2 3000 91 200 100 3 0 S/I L->R
COR T2 3000 91 220 100 3 0 R/L P->A
98
AX 3D T2 1700 320 100 2 0 R/L S->I

35
THORACIC / ABDOMINAL (AORTA) MRA
***COVER THRU BIFURCATION***

***ECG GATED***

Axial T2 Haste
Axial Cine
Sagittal OBL Cine
Axial VIBE FS Pre
Sagittal Oblique (Candy Cane) TRICKS
- Axial Reformat
- 3D MIP of Best Arterial Phase
Axial VIBE FS Post ***Subtractions*** Sagittal Oblique (Candy Cane)

***ADUST FOV TO APPROPRIATE SIZE TO COVER THE AORTA THROUGH THE BIFURCATION***
***WILL NEED TWO STACKS FOR AXIALS (CHEST & ABDOMEN COVERAGE)

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase Thickness OTHER
Frequency (mm) Direction Direction
% (mm)
AX T2 Haste 750 27 380 75 8 2 A/P S->I
AX CINE 32 3.04 380 75 8 2 A/P S->I
SAG OBL CINE 33.2 3.26 380 75 6 1.2 A/P L->R
AX VIBE FS
4.3 1.89 380 75 3 0 A/P S->I
PRE/POST
SAG OBL
2.98 1.06 380 100 1 0 A/P L->R
TRICKS

36
Mesenteric MRA

Coronal T2
Axial T2 FS BH
Axial VIBE FS Pre
Sagittal TRICKS
- Reformat into thin axial and coronal
- 3D MIP of arterial phase
Axial VIBE FS Post ***Subtractions***
Coronal VIBE FS 5 MIN Post

FOV: Slice
Gap Phase Scan
Sequence TR TE Thickness OTHER
Frequency Phase % (mm) Direction Direction
(mm)

COR T2 1600 91 440 100 5 1 R/L P->A

AX T2 FS 1600 95 380 75 5 1 A/P S->I

AX VIBE FS
4.3 1.89 380 81.3 3 1 A/P S->I
PRE/POST

SAG TRICKS 2.98 1.06 380 100 1.10 0 A/P L->R

COR VIBE FS 5
4 1.74 400 100 3 1 R/L P->A
MIN Post

37
MRA Popliteal Entrapment (Siemens ONLY)

Coronal T1
Axial T1
Sagittal T2 FS (Scan Seperately)
Coronal Plantar-Flexed DCE
- Plantar Flexion (1/2 total dose)
Coronal Dorsi-Flexed DCE
- Dorsi-Flexion (1/2 total dose)
Axial Vibe FS Post
Coronal Vibe FS Post
***FOV Mid-Thigh – Mid-Calf, Smallest FOV Possible***

FOV: Slice
Gap Phase Scan
Sequence TR TE Thickness OTHER
Frequency Phase % (mm) Direction Direction
(mm)

COR T1 400-700 10-30 280 100 3 1 R/L P->A

AX T1 400-700 10-30 280 100 3 1 A/P S->I

2000- Scan
SAG T2 FS 80-120 280 100 5 1 A/P L->R
6000 Separately

DCE (Plantar) 2.68 1.07 280 100 3 0.5 R/L P->A Tumor
Measurement

DCE (Drorsi) 2.68 1.07 280 100 3 0.5 R/L P->A Tumor
Measurements

AX Vibe FS 12.3 7.8 280 100 1/80 slab 0 R/L S->I

COR Vibe FS 12.3 7.8 280 100 1/80 slab 0 R/L P->A

38
Renal MRA
Coronal T2
To determine anatomy and location of kidneys
Axial T2 FS BH
Axial VIBE FS Pre
Coronal TRICKS Post
- Reformat into thin axial and sagittal
- 3D MIP of arterial phase
Axial VIBE FS Post ***Subtractions***
Coronal VIBE FS 5 MIN Post

FOV: Slice
Gap Phase Scan
Sequence TR TE Thickness OTHER
Frequency Phase % (mm) Direction Direction
(mm)

COR T2 1600 91 440 100 5 1 R/L P->A

AX T2 FS 1600 95 380 75 5 1 A/P S->I

AX VIBE FS PRE/POST 4.3 1.89 380 75 3 1 A/P S->I

COR TRICKS POST 2.98 1.06 380 100 1.10 0 R/L P->A

COR VIBE FS 5 MIN

4 1.74 400 100 3 1 R/L P->A
Post

39
Body AVM (Siemens ONLY)
Instructions: Place skin markers on 4 sides of the area of interest when possible. If not an arm or a leg, ask the radiologist to confirm if the planes listed are
acceptable for coverage.

Axial T2
Axial Stir
Axial T1
Axial GRE
Axial Vibe FS
Coronal 3D Tricks MRA
Axial Vibe FS Post ***Subtractions***
-(Subtraction)
***ADJUST FOV, SLICE THICKNESS/GAP ACCORDING TO BODY PART LOOKING AT***

FOV: Slice
Gap Phase Scan
Sequence TR TE Thickness OTHER
Frequency Phase % (mm) Direction Direction
(mm)

Ax T2 3100 91 200 100 3 1 A/P S->I

AX Stir 4000 50 280 100 3 1 A/P S->I

AX T1 400-700 10-30 280 100 3 1 A/P S->I

AX GRE 500 14 280 100 3 1 A/P S->I

AX VIBE FS PRE 12.3 7.8 400 100 1/80 slab 0 R/L S->I

COR TRICKS 2.98 1.06 380 100 2 1 R/L P->A

AX VIBE FS
12.3 7.8 400 100 1/80 slab 0 R/L S->I
POST

40
MRV Abdomen and/or Pelvis DVT

2D TOF – reformat into 3D image

Sat band should be placed superior to the FOV to null arterial flow
Axial VIBE FS Pre
3D MRV Pre (dry run)
3D MRV Post: Scan in 3 phases
(2min/3min/4min)
Reformat each phase into axial and sagittal
3D Coronal MIP of each phase
Axial VIBE FS Post ***Subtractions***

Coverage should include from L3-L4

down through Iliac Crest

FOV: Slice
Gap Phase Scan
Sequence TR TE Phase
Thickness OTHER
Frequency (mm) Direction Direction
% (mm)

2D TOF 458 3.7 350 50 3.5 -27 A->P S->I

AX VIBE FS Pre 6.19 2.39 340 100 3 1 R->L S->I

3D MRV Post 3.08 1.11 320 320 1 1 R->L P->A

AX VIBE FS Post 6.19 2.39 340 100 3 1 R->L S->I

41