History

There are 3 versions of this glossary term.
3. Urography Protocols

 

Date Created: 1.15.2020

Name of Protocol: 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 including slice thickness

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:

 

 
Revised By: Gayathri Sreedher Revised On: Jan 15, 2020 10:09 AM
Characters Edited: 2766 Total: 5521
2. Urography Protocols

 

MR Urography (fMRU)

 

  1. Patient Preparation:
    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

 

  1. Positioning: Prone (unless precluded by surgery, sedation issues etc… 
  1. Coverage-­‐ from diaphragm to below the bladder, A-­‐P coverage through the kidneys 
  1. 3 pre-­‐contrast sequences, one pre-­‐contrast test scan prior to gad injection, then dynamic T1 3D GRE dynamic series comprised of repetitions for 8 min or until contrast seen in the ureters; delays obtained based on clinical question.




     

    Legend: FB= free breathing, RT=respiratory triggered, BH=Breath-­‐hold;

     

     Optional sequences: 

    1. DWI axial b-­‐value (2-­‐3 b values)

     

    1. Coronal T2 SSFSE

     


    1. Concern for ectopic ureter-­‐ acquire Axial T2 FS high resolution imaging through pelvis


     

    1. Concern for calyceal diverticulum-­‐ Coronal and Sagittal 3D T1 VIBE/LAVA/THRIVE delays (at half hour, and one hour or more to identify contrast in the diverticulum)

     

    1. Concern for fibroepithelial polyp-­‐ Coronal cinematic balanced SSFP (TruFISP/FIESTA/balanced FFE)
Revised By: Gayathri Sreedher Revised On: Nov 22, 2019 10:44 PM
Characters Edited: 2731 Total: 2755
1. Urography Protocols
Information coming soon!
Revised By: Angela Davis Revised On: Nov 7, 2019 6:28 PM
Characters Edited: 0 Total: 24