Urography Protocols

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Date Created: 1.15.2020

MR Urography  

A) Preparation or initial instructions:

  1. Sedation/anesthesia-­‐ usually < 7 years of age
  2. Non-­‐sedate cases NPO 4 hours prior to scan
  3. Hydration-­‐ 20cc/kg bolus prior to imaging
  4. Bladder Catheterization-­‐ Foley catheter without balloon connected to a bag which is placed below the level of the table to facilitate bladder emptying
  5. Procedural meds-­‐ Lasix 1mg/kg (max 20 mg) given 15 min before IV gadolinium injection
  6. Positioning: Prone (unless precluded by surgery, sedation issues etc… 
  7. Coverage-­‐ from diaphragm to below the bladder, A-­‐P coverage through the kidneys 

 B) Protocol table:

Sequence Name

 

Vendor Specific name

 

Plane

Fat suppression

Motion compensation

Other relevant parameters

 

Additional info

1. T2Single Shot (2D)

 

 

T2 HASTE, SSFSE, sSH-TSE

 

Sagittal and axial

No

FB or BH based on patient age

 

 

Essential for planning oblique coronals

2. T2  (2D)

 

BLADE, PROPELLER, MultiVane

 

Axial (abdomen)

Yes

FB

 

 

Depicts scarring, dysplasia well

3. T2 (3D)

 

T2 SPACE/CUBE/VISTA

 

Coronal (isotropic)

Yes

RT or navigator

 

 

Can use to reconstruct in other planes

4.  T1 (3D)

 

VIBE/THRIVE/LAVA

 

Coronal

Yes

FB

Fast Scan

 

Pre-contrast oblique to include kidneys, ureters and bladder

5. T1 (3D) post contrast

 

VIBE, LAVA, THRIVE

 

Coronal

Yes

FB

Repeated till contrast in ureters or for 8 min

 

Can be repeated, same oblique plane as pre- contrast

Optional Sequences

 

 

 

 

 

 

 

 

 

6. DWI axial b-value ( 2-3 b values)

 

 

 

Axial

 

 

 

 

 

7. T2 SSFSE

 

T2 HASTE, SSFSE, sSH-TSE

 

Coronal

No

FB or BH based on patient age

 

 

 

8. T2

 

 

 

Axial

Yes

 

High resolution imaging through pelvis

 

Concern for ectopic ureter

9. T1 (3D)

 

VIBE, LAVA, THRIVE

 

Coronal and Sagittal

Yes

FB

 

 

Concern for calyceal diverticulum

10. Coronal cinematic balanced SSFP

 

TruFISP/FIESTA/balanced FFE

 

Coronal

Yes

RT,BH

 

 

Concern for fibroepithelial polyp

 

 

 

 

 

 

 

 

 

 

BH =Breath-hold; FB = Free Breathing;   RT = Respiratory Triggered; sSH = single-shot; T/FSE = Turbo/Fast Spin-echo

 C) References:

 

 

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