MRI MSK Protocols - ARA Diagnostic Imaging

Austin Radiological Association

MRI MSK Protocols

Adult 3T

Questions?

Last Update: 6/5/2023 10:24 AM

*3T Preferred Exams

3T MSK Protocols

General Guidelines................................................................................................................................................................................................................................... 5 1.5T and 3T Preferred Exams ................................................................................................................................................................................................................... 7 Arthrogram............................................................................................................................................................................................................................................... 8

Ankle .................................................................................................................................................................................................................................................... 9 Elbow.................................................................................................................................................................................................................................................. 10 Hip ...................................................................................................................................................................................................................................................... 11 Knee ................................................................................................................................................................................................................................................... 12 Shoulder ............................................................................................................................................................................................................................................. 13 Wrist................................................................................................................................................................................................................................................... 14 Chest Wall .............................................................................................................................................................................................................................................. 15 Joint Contrast ......................................................................................................................................................................................................................................... 16 Long Bone ? Non-specific ROI ................................................................................................................................................................................................................ 17 Long Bone ? Specific ROI........................................................................................................................................................................................................................ 18 Neurography * ....................................................................................................................................................................................................................................... 19 Knee ................................................................................................................................................................................................................................................... 19 Other Extremities ............................................................................................................................................................................................................................... 21 Upper Extremity..................................................................................................................................................................................................................................... 22 Clavicle ............................................................................................................................................................................................................................................... 22 Elbow.................................................................................................................................................................................................................................................. 23 Finger *............................................................................................................................................................................................................................................... 24 Finger: Mass / Infection * ................................................................................................................................................................................................................. 25 Hand ................................................................................................................................................................................................................................................... 26 Hand: Bilateral Praying Hands........................................................................................................................................................................................................... 27 Hand: Mass / Infection...................................................................................................................................................................................................................... 28 Pectoralis Tendon .............................................................................................................................................................................................................................. 29

Scapula ............................................................................................................................................................................................................................................... 30 Shoulder ............................................................................................................................................................................................................................................. 31 Sternum.............................................................................................................................................................................................................................................. 32 Sternoclavicular Joints ....................................................................................................................................................................................................................... 33 Thumb * ............................................................................................................................................................................................................................................. 34 Thumb: Mass / Infection * ................................................................................................................................................................................................................ 35 Wrist................................................................................................................................................................................................................................................... 36 Lower Extremity ..................................................................................................................................................................................................................................... 37 Achilles Tendon .................................................................................................................................................................................................................................. 38 Ankle .................................................................................................................................................................................................................................................. 39 Foot: Hindfoot ................................................................................................................................................................................................................................... 40 Foot: Mid or Forefoot ....................................................................................................................................................................................................................... 41 Foot: Morton's Neuroma or Contrast ............................................................................................................................................................................................... 42 Foot: Plantar Fibromatosis................................................................................................................................................................................................................ 43 Hip: Bilateral...................................................................................................................................................................................................................................... 44 Hip: Unilateral ................................................................................................................................................................................................................................... 46 Hip: Unilateral, Geriatric 70+ Y/O ..................................................................................................................................................................................................... 47 Hip: Replacement.............................................................................................................................................................................................................................. 48 Knee ................................................................................................................................................................................................................................................... 49 Knee: Metal ....................................................................................................................................................................................................................................... 50 Knee: MyKnee Surgical Planning*..................................................................................................................................................................................................... 51 Knee: Visionaire, smith&nephew...................................................................................................................................................................................................... 52 Knee: Zimmer .................................................................................................................................................................................................................................... 52 Pelvis .................................................................................................................................................................................................................................................. 53 Pelvis Contrast ................................................................................................................................................................................................................................... 54 Pelvis: MSK Athletic Pubalgia * ......................................................................................................................................................................................................... 55 Sacroiliac Joints .................................................................................................................................................................................................................................. 56 Toe *................................................................................................................................................................................................................................................... 57 Toe: Mass * ....................................................................................................................................................................................................................................... 58

Whole Body Myeloma *..................................................................................................................................................................................................................... 59

General Technique

Protocol

General Guidelines

MSK ? NEVER hesitate to reach out to a radiologist for guidance! ? All PEDI MSK arthritis exams should be performed using the standard adult protocols, unless specifically requested for pediatric

radiologist to read ? MSK Guidelines portal page reference

o T1 & T2 weighted imaging is needed to accurately differentiate mass and infection o PD's are generally useful for tendons, ligaments, & joint spaces

? Use "Weak" FS (Siemens) or "Classic" FS (GE) on all sequences with FS

? MSK known mass / infection exams should be performed using is T1 & T2 FS all 3 planes with appropriate T1 FS pre & post. Metastatic concerns do not require contrast o Always need Known mass / tumor exams - request prior x-ray study for comparison, if applicable T1 FS pre ? prior to contrast injection for direct comparison with post imaging Generally short axis to the mass is the best option for pre/post imaging T1 (generally Coronal) for ALL bone metastasis, infection, or fracture cases If contrast is contraindicated a T1 FS pre does not need to be performed

? Metal Protocols o Total joint replacements use T1 & IR series (TSE/FSE sequence types) o Hardware such as pins, screws, etc. use standard protocols with metal reduction techniques o Metal reduction techniques Bandwidth 400 Hz or more with signal compensation, fast RF mode E-line (3T & Aera) WARP on, VAT 100%

? Pelvis vs Hip o Hip ? evaluation of cartilage & labrum

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