MR AdultUrogram W/WO Protocol

Revised –3/12/2018

Charge as Abdomen W/WO
Scan time approximately 1.5 hours
Scan on MR1 or MR2. 1.5t only.
ORDERS
Ordering MD must put in orders in EPIC for IV Lasix, IV Saline, and foley catheter placement.

FOLEY CATHETER PLACEMENT
Rad RN will place and remove the catheter for outpatients. The floor nurse will place the catheter for all inpatients.

IV HYDRATION
IV hydration for one hour before studywith normal saline 4 cc/kg/hr for first 10 kg of body weight, 2 cc/kg/hr for next 10 kg of weight, and 1 cc/kg/hr for each additional kg of weight.

IV LASIX
Dosage = 0.5 mg/kg, max 20 mg. IV Lasix is given approximately 15 minutes before MR contrast.

- Outpatients: Lasix is kept in MRI.

- Inpatients: Lasix is ordered from the pharmacy.

SCAN NOTES

-Cover through the perineum. Ok to clip the liver dome if needed.

-Load Power injector with weight based gad and saline.

-Scan upper and lower axial stacks.

-Keep foley catheter at gravity to keep urinary bladder empty and facilitate visualization of the distal ureters unless otherwise instructed by radiologist.

-Call rad to check images before giving Lasix.

-Plan the sequences in advance as much as possible so you can appropriately time the Lasix injection.

Coil: Size To Patient

Loc / Mode / Slice / Gap / FAT SAT / FOV / Scan Range
AXIAL / T1 / TFE / 5mm / 1mm / None / Fit to Patient / Cover above liver through the entire perineum. Two stacks if needed.
AXIAL / T2 / TSE MV MS / 5mm / 1mm / SPIR / Fit to Patient / Cover above liver through the entire perineum. Two stacks if needed.
SAG / T2 / TSE MV MS / 5mm / 1mm / SPIR / Fit to Patient / Entire abdomen and perineum, skin to skin.
COR / T1 / TFE / 5mm / 1mm / None / Fit to Patient / Entire abdomen and perineum, skin to skin.
COR / T2 / TSE / 5mm / 1mm / SPIR / Fit to Patient / Entire abdomen and perineum, skin to skin.
COR / T2 THICK SLAB MRCP
WITH MIP / Angle as shown below to include the kidneys and bladder.
Give Lasix (Call rad to check images before giving Lasix)
COR post Lasix / T2 / TSE / 5mm / 1mm / SPIR / Fit to Patient / Entire abdomen and perineum, skin to skin.
Contrast Injection
- Inject contrast @ 0.1ml/sec. Start scan and inject gad at the same time.
- Preferred as a dynamic injection with the power injector.
- Check the Dynamic tab: “Continuous scanning” for the first 5 minutes, and then 1 dynamic every 10 seconds.
- This sequence is 20 minutes long. Once the scanner has completed running the first 5 minutes of continuous scanning it will pause and then will automatically start again for the timed delays. Don’t worry that the scanner has stopped as it’s just a timed sequence with long pauses built in. Do not stop the scan.
CorObl through the kidneys and ureters. Include bladder. / FFE / Dynamic
See above notes about injection / Fit to Patient / Don’t change the FOV of this sequence unless the patient truly doesn’t fit. If you have to change the FOV, you must check the dynamic timing to ensure it hasn’t altered. If it’s changed, you will need to manually adjust all of the dynamics.
COR / T1 / TFE / 5mm / 1mm / SPIR / Fit to Patient / Same as Pre
AXIAL / T1 / TFE / 5mm / 1mm / SPIR / Fit to Patient / Same as Pre
Cor / mDixon / FFE / 2mm / 1mm / None / Fit to Patient / Same as Pre