Pediatric MR Enterography (Smaller Patients) 3T
Siemens Healthineers – MR Gadopiclenol (VUEWAY®) Protocols
Instructions And Patient Preparation
- Instructions
- Patients should fast for at least six hours
Give oral contrast 60 mins before first sequence
An intravenous line must be placed with extension tubing extending out of the magnetic bore
Position the patient in supine position with head pointing towards the magnet
Position the patient over the spine coil and place the body coil over the pelvis
Securely tighten the body coil using straps to prevent respiratory artifacts
Give a pillow under the patient’s head for extra comfort
Instruct the patient to hold his or her breath for the breath-hold scans. It’s better to coach the patient two to three times before starting the scan.
Sedation vs bundle and feed is the ordering provider’s decision - Common Indications
- Small bowel obstruction
Small bowel mass
Crohns disease - Position
- Head First
Supine - Coil
- Body Coil
Spine Coil - Landmark
- Iliac Crest
- Patient Population
- These protocols are intended for smaller patients and serve as starting points. If a smaller FOV is needed, the parameters are modified accordingly.
Contrast Agent Parameters
| Contrast Agent | Dose | Injection Rate | Dose Timing Method and Scan Delay | |||||
|---|---|---|---|---|---|---|---|---|
| Gadopiclenol (VUEWAY) | 0.1 mL/kg | 2 mL/sec for older patients; injection rate slowed for smaller kids depending on size and age | Post-contrast series acquired after gadolinium administration | |||||
Imaging Parameters
| Scan Description | localizer_Free breathing |
localizer_bh | COR T2 HASTE FS |
COR T2 TRUFI CINE flat_breathing |
AX T2 FS HASTE BH |
AX T2 TRUFI BH |
AX DWI B50_800 |
PRE COR T1 VIBE FS |
POST 30SEC COR T1 VIBE FS |
POST COR T1 VIBE FS |
POST AX T1 VIBE FS |
|---|---|---|---|---|---|---|---|---|---|---|---|
| View Image | View Image | View Image | View Image | View Image | View Image | View Image | View Image | ||||
| Sequence Name | fl | fl | h_rr | tfi | h | tfi | epse | fl | fl | fl | fl |
| Dimension | 2D | 2D | 2D | 2D | 2D | 2D | 2D | 3D | 3D | 3D | 3D |
| Acceleration mode | GRAPPA | GRAPPA | GRAPPA | GRAPPA | GRAPPA | GRAPPA | SMS | CAIPIRINHA | CAIPIRINHA | CAIPIRINHA | CAIPIRINHA |
| CAIPIRINHA Mode | ― | ― | ― | ― | ― | ― | ― | Body Cor | Body Cor | Body Cor | Body Tra |
| Total Factor | ― | ― | ― | ― | ― | ― | ― | 4 | 4 | 4 | 4 |
| Acceleration Factor PE | 2 | 2 | 3 | 3 | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
| Acceleration Factor 3D | ― | ― | ― | ― | ― | ― | ― | 2 | 2 | 2 | 2 |
| Reference Lines PE | 24 | 24 | 42 | 24 | 40 | 24 | 50 | 24 | 24 | 24 | 24 |
| Reference Scans | Integrated | Integrated | TSE/Separate | Integrated | TSE/Separate | Integrated | GRE/Separate | GRE/Separate | GRE/Separate | GRE/Separate | GRE/Separate |
| Deep Resolve | Off | Off | Off | ― | Off | ― | Off | ― | ― | ― | ― |
Scan Parameters
| Scan Description | localizer_Free breathing |
localizer_bh | COR T2 HASTE FS |
COR T2 TRUFI CINE flat_breathing |
AX T2 FS HASTE BH |
AX T2 TRUFI BH |
AX DWI B50_800 |
PRE COR T1 VIBE FS |
POST 30SEC COR T1 VIBE FS |
POST COR T1 VIBE FS |
POST AX T1 VIBE FS |
|---|---|---|---|---|---|---|---|---|---|---|---|
| TR | 7.8 ms | 7.8 ms | 1400.0 ms | 425.45 ms | 1400.0 ms | 377.04 ms | 3800.0 ms | 4.23 ms | 4.23 ms | 4.23 ms | 3.31 ms |
| TE | 3.69 ms | 3.69 ms | 94.00 ms | 1.68 ms | 94.00 ms | 1.64 ms | 59.00 ms | 1.01 ms | 1.01 ms | 1.08 ms | 1.30 ms |
| Flip Angle | 20 deg | 20 deg | 160 deg | 54 deg | 136 deg | 51 deg | ― | 9 deg | 9 deg | 9 deg | 9 deg |
| Bandwidth | 320 Hz/Px | 320 Hz/Px | 411 Hz/Px | 1302 Hz/Px | 411 Hz/Px | 1502 Hz/Px | 2170 Hz/Px | 740 Hz/Px | 740 Hz/Px | 740 Hz/Px | 450 Hz/Px |
| Turbo Factor | ― | ― | 224 | ― | 208 | ― | ― | ― | ― | ― | ― |
| Echo Spacing | ― | ― | 5.20 ms | 3.35 ms | 5.20 ms | 3.27 ms | 0.53 ms | ― | ― | ― | ― |
| EPI Factor | ― | ― | ― | ― | ― | ― | 104 | ― | ― | ― | ― |
| Gradient Mode | Normal | Normal | Fast | Fast | Fast | Fast | Fast | Fast | Fast | Fast | Fast |
| RF Pulse Type | Normal | Normal | Fast | Normal | Fast | Normal | Low SAR | Fast | Fast | Fast | Fast |
| RF Spoiling | On | On | ― | ― | ― | ― | ― | On | On | On | On |
| Asymmetric Echo | Allowed | Allowed | ― | Off | ― | Off | ― | Weak | Weak | Weak | Weak |
| Flow Compensation | None | None | Read | ― | None | ― | ― | ― | ― | ― | ― |
| Phase Correction | ― | ― | ― | ― | ― | ― | External | ― | ― | ― | ― |
Contrast & Magnetization
| Scan Description | localizer_Free breathing |
localizer_bh | COR T2 HASTE FS |
COR T2 TRUFI CINE flat_breathing |
AX T2 FS HASTE BH |
AX T2 TRUFI BH |
AX DWI B50_800 |
PRE COR T1 VIBE FS |
POST 30SEC COR T1 VIBE FS |
POST COR T1 VIBE FS |
POST AX T1 VIBE FS |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Fat-Water Contrast | Standard | Standard | SPAIR | Standard | SPAIR | Standard | SPAIR | SPAIR | SPAIR | SPAIR | SPAIR |
| Fat Saturation | ― | ― | Strong | ― | Strong | ― | Strong | ― | ― | ― | ― |
| Magn. Preparation | None | None | None | None | None | None | None | ― | ― | ― | ― |
| MTC | Off | Off | Off | ― | Off | ― | Off | ― | ― | ― | ― |
| Dark Blood | Off | Off | Off | Off | Off | Off | ― | ― | ― | ― | ― |
| Contrasts | 1 | 1 | 1 | 1 | 1 | 1 | ― | 1 | 1 | 1 | 1 |
| Reconstruction | Magnitude | Magnitude | Magnitude | Magnitude | Magnitude | Magnitude | Magnitude | Magnitude | Magnitude | Magnitude | Magnitude |
| Wrap-up Magn. | ― | ― | None | Restore | None | Restore | ― | ― | ― | ― | ― |
Acquisition Parameters
| Scan Description | localizer_Free breathing |
localizer_bh | COR T2 HASTE FS |
COR T2 TRUFI CINE flat_breathing |
AX T2 FS HASTE BH |
AX T2 TRUFI BH |
AX DWI B50_800 |
PRE COR T1 VIBE FS |
POST 30SEC COR T1 VIBE FS |
POST COR T1 VIBE FS |
POST AX T1 VIBE FS |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Base Resolution | 256 | 256 | 320 | 256 | 320 | 256 | 128 | 320 | 320 | 320 | 320 |
| Phase Resolution | 70 % | 70 % | 70 % | 100 % | 80 % | 100 % | 100 % | 60 % | 60 % | 60 % | 75 % |
| Slice Resolution | ― | ― | ― | ― | ― | ― | ― | 50 % | 50 % | 50 % | 50 % |
| Averages | 1 | 1 | 1 | 1 | 1 | 1 | ― | 1 | 1 | 1 | 1 |
| Concatenations | 23 | 23 | 4 | 14 | 4 | ― | 1 | 1 | 1 | 1 | 1 |
| FoV Read | 430 mm | 430 mm | 368 mm | 450 mm | 400 mm | 400 mm | 400 mm | 450 mm | 450 mm | 380 mm | 380 mm |
| FoV Phase | 100.0 % | 100.0 % | 100.0 % | 100.0 % | 81.3 % | 81.3 % | 81.3 % | 100.0 % | 100.0 % | 100.0 % | 81.3 % |
| Phase Encoding Dir. | A >> P | A >> P | R >> L | R >> L | A >> P | A >> P | A >> P | R >> L | R >> L | R >> L | A >> P |
| Phase Oversampling | 25 % | 25 % | 50 % | 30 % | 0 % | 0 % | 0 % | 20 % | 20 % | 20 % | 0 % |
| Slice Oversampling | ― | ― | ― | ― | ― | ― | ― | 38.5 % | 38.5 % | 33.3 % | 30.0 % |
| Phase Partial Fourier | 6/8 | 6/8 | 5/8 | Off | 5/8 | 7/8 | Off | 6/8 | 6/8 | 6/8 | Off |
| Slice Partial Fourier | ― | ― | ― | ― | ― | ― | ― | 5/8 | 5/8 | 5/8 | 7/8 |
| Interpolation | On | On | 1.00 | On | 1.00 | On | On | Off | Off | Off | Off |
| Trajectory | ― | ― | ― | Cartesian | ― | Cartesian | ― | Cartesian | Cartesian | Cartesian | Cartesian |
| Multi-Slice Mode | Sequential | Sequential | Single Shot | Sequential | Single Shot | Sequential | Interleaved | ― | ― | ― | ― |
Scanning Range
| Scan Description | localizer_Free breathing |
localizer_bh | COR T2 HASTE FS |
COR T2 TRUFI CINE flat_breathing |
AX T2 FS HASTE BH |
AX T2 TRUFI BH |
AX DWI B50_800 |
PRE COR T1 VIBE FS |
POST 30SEC COR T1 VIBE FS |
POST COR T1 VIBE FS |
POST AX T1 VIBE FS |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Slice Thickness | 7.0 mm | 7.0 mm | 4.0 mm | 10.0 mm | 4.0 mm | 4.0 mm | 4.0 mm | 2.5 mm | 2.5 mm | 1.5 mm | 3.0 mm |
| Slices | 5 Slices | 5 Slices | 48 Slices | 14 Slices | 48 Slices | 48 Slices | 48 Slices | 104 Slices per Slab |
104 Slices per Slab |
144 Slices per Slab |
80 Slices per Slab |
| Distance Factor | 150 % | 150 % | 20 % | 20 % | 20 % | 20 % | 20 % | 20 % | 20 % | 20 % | 20 % |
| Special Saturation | None | None | None | None | Parallel F/H | None | None | None | None | None | None |
| Raw Filter | Off | Off | Off | Off | Off | Off | On | Off | Off | Off | Off |
| Elliptical Filter | Off | Off | Off | Off | Off | Off | Off | Off | Off | Off | Off |
| Image Filter | Off | Off | On | On | On | On | ― | On | On | On | Off |
| Distortion Correction | 2D | 2D | 2D | 2D | 2D | 2D | 2D | 2D | 2D | 2D | 2D |
| Normalize | Prescan | Prescan | Prescan | Prescan | Prescan | Prescan | Prescan | Prescan | Prescan | Prescan | Prescan |
| Noise Masking | ― | ― | ― | ― | ― | ― | Off | Off | Off | Off | Off |
| Time of Acquisition | 19 sec | 19 sec | 1:37 min | 5:00 min | 1:37 min | 18 sec | 2:17 min | 13 sec | 13 sec | 16 sec | 14 sec |
Diffusion
| Scan Description | localizer_Free breathing |
localizer_bh | COR T2 HASTE FS |
COR T2 TRUFI CINE flat_breathing |
AX T2 FS HASTE BH |
AX T2 TRUFI BH |
AX DWI B50_800 |
PRE COR T1 VIBE FS |
POST 30SEC COR T1 VIBE FS |
POST COR T1 VIBE FS |
POST AX T1 VIBE FS |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Diffusion Mode | ― | ― | ― | ― | ― | ― | 3D Diagonal | ― | ― | ― | ― |
| Diffusion Scheme | ― | ― | ― | ― | ― | ― | Monopolar | ― | ― | ― | ― |
| Diff. Directions | ― | ― | ― | ― | ― | ― | 1 | ― | ― | ― | ― |
| b-value 1 | ― | ― | ― | ― | ― | ― | 50 s/mm² | ― | ― | ― | ― |
| b-value 2 | ― | ― | ― | ― | ― | ― | 800 s/mm² | ― | ― | ― | ― |
| Averages b-value 1 | ― | ― | ― | ― | ― | ― | 5 | ― | ― | ― | ― |
| Averages b-value 2 | ― | ― | ― | ― | ― | ― | 20 | ― | ― | ― | ― |
| Diff. Weightings | ― | ― | ― | ― | ― | ― | 2 | ― | ― | ― | ― |
| Diff. Weighted Images | ― | ― | ― | ― | ― | ― | On | ― | ― | ― | ― |
| Trace Weighted Images | ― | ― | ― | ― | ― | ― | Off | ― | ― | ― | ― |
| ADC Maps | ― | ― | ― | ― | ― | ― | On | ― | ― | ― | ― |
| Exponential ADC Maps | ― | ― | ― | ― | ― | ― | Off | ― | ― | ― | ― |
| FA Maps | ― | ― | ― | ― | ― | ― | Off | ― | ― | ― | ― |
| Calculated Image | ― | ― | ― | ― | ― | ― | Off | ― | ― | ― | ― |
Physio / Gating
| Scan Description | localizer_Free breathing |
localizer_bh | COR T2 HASTE FS |
COR T2 TRUFI CINE flat_breathing |
AX T2 FS HASTE BH |
AX T2 TRUFI BH |
AX DWI B50_800 |
PRE COR T1 VIBE FS |
POST 30SEC COR T1 VIBE FS |
POST COR T1 VIBE FS |
POST AX T1 VIBE FS |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1st Signal/Mode | None | None | None | None | None | None | None | ― | ― | ― | ― |
| Resp. Control | Off | Off | Breath-hold | Off | Breath-hold | Breath-hold | Off | Breath-hold | Breath-hold | Breath-hold | Breath-hold |
Post-Processing / Inline
| Scan Description | localizer_Free breathing |
localizer_bh | COR T2 HASTE FS |
COR T2 TRUFI CINE flat_breathing |
AX T2 FS HASTE BH |
AX T2 TRUFI BH |
AX DWI B50_800 |
PRE COR T1 VIBE FS |
POST 30SEC COR T1 VIBE FS |
POST COR T1 VIBE FS |
POST AX T1 VIBE FS |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Subtract | Off | Off | Off | Off | Off | Off | ― | Off | Off | Off | Off |
| Subtract Measurements | 1 | 1 | 1 | 1 | 1 | 1 | ― | 1 | 1 | 1 | 1 |
| StdDev | Off | Off | Off | Off | Off | Off | ― | Off | Off | Off | Off |
| MIP Sagittal | Off | Off | Off | Off | Off | Off | ― | Off | Off | Off | Off |
| MIP Coronal | Off | Off | Off | Off | Off | Off | ― | Off | Off | Off | Off |
| MIP Transversal | Off | Off | Off | Off | Off | Off | ― | Off | Off | Off | Off |
| MIP Time | Off | Off | Off | Off | Off | Off | ― | Off | Off | Off | Off |
| Radial MIP | Off | Off | Off | Off | Off | Off | ― | Off | Off | Off | Off |
| MPR Sagittal | Off | Off | Off | Off | Off | Off | ― | Off | Off | Off | Off |
| MPR Coronal | Off | Off | Off | Off | Off | Off | ― | Off | Off | Off | Off |
| MPR Transversal | Off | Off | Off | Off | Off | Off | ― | Off | Off | Off | Off |
| Inline Composing | On | On | On | Off | On | On | ― | Off | Off | On | On |