chapter 7-1 flute - carotids...author: hitachi subject: oasis mri system created date: 1/31/2013...

1 Prep the power injector unit to

Chapter 7-1 FLUTE - Carotids1 p p j

administer the main bolus of contrast followed by saline.

Dosage and rate will be determined by the Radiologist

2

2 Place trough pads A, C, and D on the table. Place the RAPID Neuro Vascular coil on the table 3

determined by the Radiologist.

along with table pads H and F, as shown.

If your site does not have the RAPID Neuro Vascular coil, the RAPID C i l C il b dRAPID Cervical Coil can be used, but coverage of the Aortic Arch and Circle of Willis may be sub-optimal.

3 Place the patient on the table within the coil, as shown.Caution: In both test injection and the main within the coil, as shown.

Align the laser to the sternal notch of the patient.

Press and hold the SET button

4

5

jscan, the total volume of the contrast agent and saline as well as injection rate should be equal. By doing this, the vessels will be at their highest contrast. Varying the total volume and its injection rate will alter the time the contrast reaches the target vessel

hi h ill d th t t f th

For detailed safety information, refer to Chapter 1, “Safety” in theOasis MR system Reference

7-1Copyright 2012 by Hitachi Medical Systems America, Inc. All rights reserved. DM# 86716v1

Press and hold the SET button to advance the patient to isocenter.

5which will reduce the contrast of the vessel. Manual.

Chapter 7-1 FLUTE - Carotids

7Load your site’s FLUTE Carotids protocol. If your site does not have one, select the FLUTE Carotids protocol from the System library.

6

Select the Scanogram SCAtask, then click . 7

8

Select the Scanogram 2D TOF Sag w/ MIP task.8

9

Load the Scanogram SCA images.9Position the slice group as displayed at left.

Click

9


Chapter 7-1 FLUTE - CarotidsSelect the Pre/Post FLUTE10

Load the Scanogram SCA and Scanogram 2D TOF Sag 11

Select the Pre/Post FLUTE Carotids task.

1010

g gw/ MIP images.Position the slice group as displayed, ensuring coverage of the carotid and vertebral arteriesarteries.

Select the Fluoro Scan task.Position the slice group as displayed centering on the carotid

1212 displayed, centering on the carotid

arteries and low enough to cover the pulmonary arteries.

13 Click to begin the 13 pre-contrast (mask) scan.After completing the pre-contrast (mask) the system will pause. Ensure good image quality

7-3Copyright 2012 by Hitachi Medical Systems America, Inc. All rights reserved.

before continuing.

DM# 86716v1

Chapter 7-1 FLUTE - Carotids

Prep the power injector. Dosage and rate will be determined by the Radiologist.

14

Click to begin the Fluoro Scan.

15

Begin the contrast injection of 16

15Fluoro Images

Subtracted Fluoro Images

g jthe entire contrast bolus, followed by saline.

16

17 As soon as the contrast is seen in the carotid arteries, select .

17Shortly after the pulmonary arteries (C) are seen, the aortic arch (D) will enhance and then the carotid arteries (E)

A B C D E HINT:


(E).

DM# 86716v1

Chapter 7-1 FLUTE - Carotids18

18 Select the MIP task.Load the FLUTE Carotid images into the MIP task.

18

19 In the Acquisition No. box, enter or select 2. In the Acquisition Scope list, click Current.

20 Perform MIP functions.

Refer to Chapter 5, Post Processing, for MIP steps.

19


P th i j t it t

Chapter 7-2 FLUTE - Renals2 1 Prep the power injector unit to

administer the main bolus of contrast followed by saline.Dosage and rate will be determined by the

2

2

yRadiologist.

Place the RAPID Body coil on the table. Place trough Pads A and D and table pad F on the

3 Place the patient on the table within the coil as shown

and D and table pad F on the table as shown.3

within the coil, as shown.

Align the laser to the center of the RAPID Body coil.4

Press and hold the Set button to advance the patient to isocenter.5

Caution: In both test injection and the main scan, the total volume of the contrast agent and saline as well as injection rate should be equal. By doing this, the vessels will be at their highest contrast. Varying the total volume and its injection rate will alter the


jtime the contrast reaches the target vessel which will reduce the contrast of the vessel.

DM# 86716v1

Chapter 7-2 FLUTE - Renals

It is recommended that all sequences in this protocol be performed using breath-holding techniques.

7

86 Load your site’s FLUTE Renals

protocol. If your site does not have one, select the FLUTE Renals protocol from the System library.

9

7 Select the Scanogram SCA task, then click .

Select the Cor BASG task.9

Select the Shim Axial task, then click .8

Load the Scanogram SCA images.Position the slice group as displayed at left.Click .

9


C c

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Select the Axial BASG task.

Load the Scanogram SCA images.

10 10

Position the slice group as displayed at left.Click .

11 Select the Scanogram 2D TOF Sag w/ MIP task.

11


Position the slice group as displayed at left.

Click .


Chapter 7-2 FLUTE - RenalsSelect the Pre/Post FLUTE1212

Load the Cor BASG, Sag BASG and Scanogram 2D TOF Sag w/ MIP images.

13

12Select the Pre/Post FLUTE Renals task.

12

MIP images. Position the slice group as displayed at left, ensuring coverage of the anterior aorta and at least half of the kidneys.

Select the Fluoro Scan task.Position the slice group as displayed, centering on the aorta

14

aorta.14

15 Click to begin the pre-contrast (mask) scan.

After completing the pre-contrast (mask), the system will pause. Ensure good image quality before continuing.



Cli k t b i th Fl

Prep the power injector.Dosage and rate will be determined by the Radiologist.

16

Click to begin the Fluoro Scan task.Do not breath-hold the Fluoro Scan task.Live images will be generated

17

Live images will be generated in the Fluoro viewports.

17Fluoro Images

Subtracted Fluoro Images

Begin the contrast injection of the entire contrast bolus, followed by saline.

18 As soon as the contrast is seen in the descending aorta, clickclick .

Note: After clicking ,there will be a three to five second pause when using Auto Voice. The amount of time

18


Voice. The amount of time depends on the Auto Voice settings.

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19 Select the MIP task.

Load the FLUTE Renals images into the MIP task.

19

20 In the Acquisition No. Box, enter or select 2. In the Acquisition Scope list, click Current.


20


20


P th i j t it t

Chapter 7-3 TRAQ - Renals2 1 Prep the power injector unit to

administer the main bolus of contrast followed by saline.

Dosage and rate will be d t i d b th

2

2


Place the RAPID Body coil on the table. Place trough pads A

d D d t bl d F th3

3 Place the patient on the table

and D and table pad F on the table as shown.

3

3 within the coil, as shown.

Align the laser to the center of the RAPID Body coil.4 the RAPID Body coil.





DM# 86716v1

Chapter 7-3 TRAQ - Renals


7

86 Load your site’s TRAQ Renals

protocol. If your site does not have one, select the TRAQ Renals protocol from the System library.9

7 Select the Scanogram SCA task, then click . 9


8 Select the Shim Axial task, then click .

Load the Scanogram SCA images.Position the slice group as displayed at left.


Click .

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Select the Axial BASG task.


10 10



Click .

11S l t th S 2D TOF11 Select the Scanogram 2D TOF Sag w/ MIP task.



Click .


Select the TRAQ Renal task


12 Select the TRAQ Renal task.

Load the Cor BASG, Ax BASG and Scanogram 2D TOF Sag w/ MIP images.

13

12

12

13

MIP images.Position the slice group as displayed, ensuring coverage of the anterior aorta and at least half of the kidneys.

1413

Prep the power injector unit to administer the main bolus of contrast followed by saline. Dosage and rate will be determined by the

15


Click and wait for the prescan to complete. The continue button will appearwill appear.

Click and the INJECT button on the power injector at the SAMEtime.The patient should be instructed to


The patient should be instructed to hold their breath as long as possible.

DM# 86716v1


16 Select the MIP task.

Load the TRAQ Renal images into the MIP task.

16

17 In the Acquisition No. box, enter or select the number of the best image group. In the Acquisition Scope list, click Current.


To create a dynamic MIP 19

17

yseries, set Acquisition Scopelist to Whole. Perform routine MIP functions, then click .

19

R f t Ch t 5 P t17 Refer to Chapter 5, Post Processing, for MIP steps.


Prep the power injector unit to

Chapter 7-4 Timed Bolus - Renals

2 1 Prep the power injector unit to administer the main bolus of contrast followed by saline.Dosage and rate will be determined by the

2

2

Radiologist.

Place the RAPID Body coil on the table. Place trough pads A and D and table pad F on the 3

3 Place the patient on the table within the coil, as shown.

table as shown.3

,

Align the laser to the center of the RAPID Body coil.4





DM# 86716v1

Chapter 7-4 Timed Bolus - RenalsIt is recommended that all7

L d it ’ Ti d B l


7

86 Load your site’s Timed Bolus

Renals protocol. If your site does not have one, select the Timed Bolus Renals protocol from the System library.

9

7 Select the Scanogram SCA task, then click .9


8 Select the Shim Axial task, then click .

Load the Scanogram SCA images.Position the slice group as displayed at left.Click .

9


C c

DM# 86716v1


Select the Axial BASG task.Load the Scanogram SCA images.

10 10

Position the slice group as displayed at left.Click .

1111

Select the Scanogram 2D TOF Sag w/ MIP task.



Click .


Chapter 7-4 Timed Bolus - RenalsSelect the Test Injection task1212 Select the Test Injection task.Load the Cor BASG, Ax BASG and Scanogram 2D TOF Sag w/ MIP images. Position the slice group as displayed at left, between the renal arteries and the aortic bifurcation

1212

arteries and the aortic bifurcation.

Click . The system will perform a prescan, then the system will pause and the button will change tochange to .

13 Prep the power injector unit to administer the predetermined amount of contrast and saline by the radiologist This test injection

Fluoro Images Subtracted fluoro Images

the radiologist. This test injection rate should be the same as the main bolus rate from Step 1.

14 Select and the inject button on the power injector at the SAME14 on the power injector at the SAMEtime. Fluoro images will be displayed in the lower-left viewport. Click after contrast has

d th h th t


The Aorta will appear dark at first, then will become bright as contrast passes through it. Once the aorta is dark again, click Abort.

passed through the aorta.

DM# 86716v1

Chapter 7-4 Timed Bolus - RenalsSelect the Timing Graph task.1515 Se ect t e g G ap tasLoad the Test Injection images.15

16 On the Overlays menu, point to Add ROI, then click Ellipse to add an elliptical-shaped ROI

15

add an elliptical shaped ROI.Draw an ellipse over the aorta.Click Apply to All .

17 A graphical representation of the bolus is displayed allowing

16bolus is displayed, allowing visualization of the bolus arrival.

18 For additional confirmation of the bolus arrival time, point to then 17 click Dynamic Data Table. The Dynamic Analysis Table window is displayed.

Select the highest ROI value and

17

18

the corresponding Acquisition Time.

19 Add four seconds to the bolus arrival time. This is the time that

ill b d th T l Ti

18


will be used as the Travel Time.

DM# 86716v1

Select the Renals task


2020 Select the Renals task.

21Load the Cor BASG, Ax BASG and Scanogram 2D TOF Sag w/ MIP i

21

2020

MIP images.Position the slice group as displayed at left, ensuring coverage of the anterior aorta and at least half of the kidneys.

22 In the Travel Time box, under the Scan Control area in the Scan Parameters window, enter the T l Ti f St 19

y

23

Travel Time from Step 19.

22Click to begin the pre-contrast scan (mask).

The use of Auto Voice is recommended when performing Breath-Hold instructions for the main scan

Note:


scan.

DM# 86716v1


24 After the pre-contrast (mask) scan has been performed, review the images to ensure proper coverage and good image quality.

25 Prep the power injector unit to administer the main bolus of contrast, followed by saline.

Caution: In both test injection and the main scan, the total volume of the contrast agent and saline as well as injection rate should be equal. By doing this, the vessels will be

26 Select and the inject button on the power injector at the SAMEti

at their highest contrast. Varying the total volume and its injection rate will alter the time the contrast reaches the target vessel which will reduce the contrast of the vessel.

time.



27 Select the MIP task.Load the Timed Bolus Renal images into the MIP task.

27

28 In the Acquisition No. box, enter or select 2. In the Acquisition Scope list, click Current.


28


28


chapter 7-1 flute - carotids...author: hitachi subject: oasis mri system created date: 1/31/2013...

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