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TRA Medical Imaging

General Comments: Perform sequences in order listed as best as possible.

Coil: Head

Axial Coverage: Vertex through foramen magnum

Sagittal Coverage: Ear through opposite ear

Coronal Coverage: Forehead through occiput



Routine Adult Brain w/o contrast

Sag T1

Ax Diffusion

Ax T2

Ax FLAIR

Ax T2*

Ax T1

Sag MPR


Routine Adult Brain w/contrast

Sag T1

Ax Diffusion

Ax T2

Ax FLAIR

Ax T2*

Ax T1 pre

Ax T1 post

Sag MPR post


Pediatric Brain – General Comments

Chiari I malformation: Consult with a Radiologist about additional imaging

Add a Sag CSF flow study at foramen magnum.

Add Sag T2 of entire spine for evaluation of syrinx.

Routine Pediatric Brain < 1y/o w/o contrast

Sag MPR

Ax Diffusion

Ax T2

Ax FLAIR

Ax T2*

Ax T1

Ax T1 IR

Cor T2


Routine Pediatric Brain < 1y/o w/contrast

Sag MPR

Ax Diffusion

Ax T2

Ax FLAIR

Ax T2*

Ax T1

Ax T1 IR

Cor T2

Ax T1 post

Sag MPR post


Routine Pediatric Brain < 18 y/o w/o contrast

Sag MPR

Ax Diffusion

Ax T2

Ax FLAIR

Ax T2*

Ax T1

Cor T2


Routine Pediatric Brain < 18 y/o w/contrast

Sag MPR

Ax Diffusion

Ax T2

Ax FLAIR

Ax T2*

Ax T1

Cor T2

Ax T1 post

Sag MPR post


Spectroscopy (TRA Union and TG only)

Comments: ALWAYS Discuss with Neuroradiologist before study if at all possible

Perform on non-contrast exam if possible

Single Voxels through area of abnormality

Single Voxels through similar area on contralateral side of brain

Multi Voxel through area abnormality

Generate spectral map of lesion

Submit multiple tracings from spectral map after discussion with Radiologist


Multiple Sclerosis w/o contrast

Use: Confirmed multiple sclerosis only. If suspected then perform Routine Adult Brain MRI with addition of Sag FLAIR.

Ax Diffusion

Ax T2

Ax FLAIR (3 mm)

Ax T1

Sag FLAIR (3mm)

Sag MPR

**at SJ 3T only, add ax PD through posterior fossa as a trial**


Multiple Sclerosis w/ contrast

Use: Confirmed multiple sclerosis only. If suspected then perform Routine Adult Brain MRI with addition of Sag FLAIR.

Ax Diffusion

Ax T2

Ax FLAIR (3 mm)

Ax T1

Sag FLAIR (3 mm)

Sag MPR post

Ax T1 post (3 mm)

**at SJ 3T only, add ax PD through posterior fossa as a trial**


Seizure/Epilepsy Brain w/o contrast

Use: Suspect mesial temporal sclerosis or long standing seizures.

DO NOT use for first time seizure, perform routine brain.

Cor MPR angled through temporal lobes to include whole brain

Ax Diffusion

Ax FLAIR

Ax T1

Ax T2

Ax T2*

Cor thin FLAIR through temporal lobes

Cor thin T2 through temporal lobes


Seizure/Epilepsy Brain w/contrast

Use: Suspect mesial temporal sclerosis or long standing seizures.

DO NOT use for first time seizure, perform routine brain.

Cor MPR angled through temporal lobes to include whole brain

Ax Diffusion

Ax FLAIR

Ax T1

Ax T2

Ax T2*

Cor thin FLAIR through temporal lobes

Cor thin T2 through temporal lobes

Sag MPR post

Ax T1 post


Headframe/Fiducial Preoperative Brain w/contrast (Inpatient only)

Ax MPR

Ax MPR post

Ax double echo T2


Post Gamma Knife Therapy Brain w/o contrast (St. Joe’s only)

Sag T1

Ax Diffusion

Ax MPR

Ax T2

Ax FLAIR

Ax T1

Ax T2*

Sag MPR


Post Gamma Knife Therapy Brain w/ contrast (St. Joe’s only)

Sag T1

Ax Diffusion

Ax MPR

Ax T2

Ax FLAIR

Ax T1

Ax T2*

Ax T1 post

Ax MPR post

Sag MPR post