Liver DYNAMIC MultiHance/Primovist protocol_SPR
- Coverage: upper abdomen up to lower pole of kidneys
- Good for any focal liver lesion, especially FNH.
- Good for portal hypertension with focal liver lesion and bile leaks
- Contrast injection happens within first 5 min of scanning. Be ready with dynamic injection set up while taking the patient on table.
- Good for any mass in upper abdomen in organs like spleen, pancreas, adrenal and kidneys
- Approx 30 min of sequences time but table time will be at least 50 min with Multihance due to wait time for delayed images
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Sequence Name
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Vendor Specific name
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Plane
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Fat suppression
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Motion compensation
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Other relevant parameters
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Additional info
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1. T2 SSFSE
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T2 HASTE or T2 single-shot
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Coronal
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Yes
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Free Breathing(FB) in smaller or breath-hold (BH) in older children
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2. T1 3D GRE
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VIBE/THRIVE/LAVA
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Coronal
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By default in the sequence
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BH or FB
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3. In-and-out-phase imaging
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T1 In and out-phase
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Ax
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BH or FB
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TEs- 2.3 and 4.6ms on 1.5T; 2.3 and 1.15ms on 3T
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4. T1 3D GRE Pre-Gad
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VIBE/THRIVE/LAVA
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Ax
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By default
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BH or FB
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Dynamic IV MultiHance or Primovist at approx 1-3 ml/sec. After a delay of 10 sec start breathing instruction for first run
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5. T1 3D GRE Dynamic 4 runs
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VIBE/THRIVE/LAVA
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Ax
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By default
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BH or FB
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2 NSA in small children with free breathing.
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4 runs: Gap of only breathing instruction between runs 1&2; give a gap of 15 sec between runs 2 & 3 and 3 & 4).
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6. T1 3D GRE
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VIBE/THRIVE/LAVA
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Coronal
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By default
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BH or FB
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7. T1 SE
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T1 FSE/TSE
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Ax
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Yes
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FB
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6 NSA
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8. T1 3D GRE Delayed
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VIBE/THRIVE/LAVA
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Ax
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By default
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BH or FB
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9. Balanced SSFP
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B-TFE/TruFISP/FIESTA
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Ax
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No
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BH or RT
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10. T2
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T2 FSE/TSE
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Ax
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Yes
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RT
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11. DWI
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DWI
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Ax
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Default
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FB or RT
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b-values: 0, 100 and 600-800
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Delayed “hepatobiliary phase” imaging: at 20 minutes for Primovist and between 45-60 min for Multihance after gad injection.
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12. T1 3D GRE Hepatobiliary phase
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VIBE/THRIVE/LAVA
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Ax
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By default
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BH or FB
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Ax = axial; Cor = coronal; BH =Breath-hold; FB = Free Breathing; FS = fat sat; RT = Respiratory Triggered; sSH = single-shot; DWI = diffusion weighted imaging; NSA = number of signal averages (Nex); T/FSE = Turbo/Fast Spin-echo
OPTIONAL
1Ax T2 FS (TE 200 for Hemangioma)
2 Phase contrast flow quantification in portal hypertension
References:
Chavhan GB, Shelmerdine SC, Jhaveri K, Babyn PS. Liver MRI in Children: Current Concepts and Technique. Radiographics. 2016 Sep-Oct; 36(5):1517-32.