Spine imaging of challenging patients using Ingenia

Transcription

1 Publication for the Philips MRI Community Issue /1 Spine imaging of challenging patients using Ingenia Contributed by Lars van Loon and Wendy Hopkins, MR Application, Best, The Netherlands Publication for the Philips MRI Community Issue /1 Users on Ingenia Ingenia 1.5T helps advance MRA at utrecht, is a neuro workhorse at OHsu Ingenia 3.0T excels in cardiac MR at sleh, in high detail MsK at PAMF, in fast high quality DWIBs at Tokai Impressive workflow benefits and quality imaging with Ingenia 1.5T at Nemoscan and Ingenia 3.0T in Trier This article is part of FieldStrength issue /1

2 34 Application tips Contributed by Lars van Loon and Wendy Hopkins, MR Application, Best, The Netherlands Spine imaging of challenging patients using Ingenia Ingenia is designed for simplified, fast workflow. Ingenia makes it easy to scan challenging patients, especially in the clinical area of the spine. Not everyone is able to lie completely flat in the MR for a study. For patients with kyphosis or those who have difficulty swallowing or breathing when lying flat, it can be very challenging to lie still for the time it takes to achieve a high quality exam. That s why we need a solution to image these patients without a significant trade-off in resolution and/or scan time. TIP 1 Spine imaging with tilted ds HeadNeckSpine coil solution The FlexTilt coil tilting device is designed for patients who do not like to be closed in, such as patients suffering from claustrophobia, and for patients who just can t lie flat. FlexTilt provides an alternative way to image these challenging patients with easy, fast positioning and scanning. The tilting device works with either the ds HeadSpine or ds HeadNeckSpine coil solutions. It allows tilting the ds HeadNeckSpine coil in increments from 0-20 degrees. FlexTilt is designed to accommodate claustrophobic patients and patients with kyphotic spines for instance, who could not comfortably tolerate imaging previously. Setup of the base of the ds HeadNeckSpine coil solution when it is tilted. 34 FieldStrength Issue /1

3 TIP 2 Use SmartExam with tilted ds HeadNeckSpine solution It is possible to use SmartExam with the tilted ds HeadNeckSpine solution to obtain excellent automatic planning and automatic numbering of vertebrae. Example of the correct Smart Planning with tilted ds HeadNeckSpine coil solution. SmartExam study with sagittal T2 (left) and T1 (right) with large FH coverage of 380 mm. Setup with the top of the ds HeadNeckSpine coil solution added. With tilted coil the patient can look out of the tunnel without obstruction when the head is at isocenter. FieldStrength 35

4 Application tips TIP 3 Fast Cervical Spine imaging in 8 minutes dstream digitizes the signal directly in the coil at the patient, which provides higher SNR and signal fidelity than a (partly) analog pathway. This increase in SNR can be used for faster scanning, while still maintaining superb resolution. A full, high-resolution cervical spine study can be completed within 8 minutes. A transverse cervical spine (C2-T1) is included in this protocol. The fast cervical spine ExamCards are available in the scanner database for Ingenia 1.5T and 3.0T. Fast T1 and T2 sagittal Fast 3D T2 transverse Fast B_FFE Parameters of fast cervical spine sequences for Ingenia 1.5T Ingenia 1.5T T2 sag T1 sag T2 3D ax B_FFE ax Scan time 1:45 min. 1:51 min. 2:08 min. 1:05 min. Pixels [mm] 0.9 x x x x 0.9 Slice thickness [mm] FOV AP, FH, RL [mm] 160, 220, , 220, , 100, , 100, 120 SENSE factor x 1.5 Parameters of fast cervical spine sequences for Ingenia 3.0T Ingenia 3.0T T2 sag T1 sag T2 3D ax B_FFE ax Scan time 1:15 min. 2:20 min. 2:20 min. 1:32 min. Pixels [mm] 0.9 x x x x 0.75 Slice thickness [mm] FOV AP, FH, RL [mm] 160, 220, , 220, , 80, , 80, 120 SENSE factor x x FieldStrength Issue /1

5 TIP 4 Fast imaging of the complete spine in two stations Because of the Xtend imaging space there is outstanding magnet homogeneity delivering a homogenous field of view up to 55 x 55 x 50 cm, making it possible to perform 2-station total spine exams instead of 3-station total spine exams, both on 1.5T and 3.0T. On Ingenia, this procedure does not require any coil or cable handling; the patient simply needs to lie down on the table and positioning is done, fast and easy. In addition, with SmartSelect the technologist no longer needs to select coil elements; it is done automatically. SmartSelect picks the most optimal channels needed to provide the best SNR in the chosen FOV of the exam, to help get a first-time-right exam and may reduce re-scans. The 2-station total spine ExamCards are available in the scanner database for Ingenia 1.5T and 3.0T. Parameters of 2-station spine for 1.5T Ingenia 1.5T T2 sagittal T1 sagittal Scan time 2:34 min. per station 2:38 min. per station Pixels 0.96 x 1.2 mm 0.96 x 1.2 mm Slice thickness 4 mm 4 mm FOV 370 mm per station 370 mm per station Parameters of 2-station spine for 3.0T Ingenia 3.0T T2 sagittal T1 sagittal Scan time 2:50 min. per station 3:01 min. per station Pixels 0.95 x 1.15 mm 0.95 x 1.15 mm Slice thickness 4 mm 4 mm FOV 360 mm per station 360 mm per station T1 and T2 sagittal in 2 stations. NetForum Visit the online Philips NetForum community for more application tips. FieldStrength 37