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Internal auditory canals (IAC) w/contrast:

Use: Asymmetric hearing loss, R/O acoustic neuroma, routine Kevin Kennedy case

DO NOT use for dizziness, use routine brain.

Sag T1

Ax Diffusion

Ax FLAIR

Ax T2

Ax CISS posterior fossa

Ax T1 thin posterior fossa

Cor T1 fat sat thru IAC

Ax T1 post posterior fossa

Cor T1 fat sat post thru IAC

Sag MPR post thru brain


Internal auditory canals (IAC) w/o contrast:

Use: Asymmetric hearing loss, R/O acoustic neuroma, routine Kevin Kennedy case DO NOT use for dizziness, use routine brain.

Only to be used if there is a strong contraindication for contrast.

Sag T1

Ax Diffusion

Ax FLAIR

Ax T2

Ax CISS posterior fossa

Ax T1 thin posterior fossa

Cor T1 fat sat thru IAC

Sag MPR thru brain


Screening IAC:

Ax CISS posterior fossa


Trigeminal Neuralgia w/contrast:

FOV: Similar routine for IACs, but centered at Meckel’s Cave

Sag T1

Ax Diffusion

Ax FLAIR

Ax T2

Ax CISS Meckel’s cave

Ax T1 thin Meckel’s cave

Cor T1 fat sat thru Meckel’s cave and brainstem

Ax T1 post Meckel’s cave

Cor T1 fat sat post thru Meckel’s cave and brainstem

Sag MPR post thru brain


Trigeminal Neuralgia w/o contrast:

FOV: Similar routine for IACs, but centered at Meckel’s Cave. Only to be used if there is a strong contraindication for contrast.

Sag T1

Ax Diffusion

Ax FLAIR

Ax T2

Ax CISS Meckel’s cave

Ax T1 thin Meckel’s cave

Cor T1 fat sat thru Meckel’s cave and brainstem


Cranial Nerve w/contrast:

Use: Perineural spread of tumor, skull base tumors

Consult Radiologist with regards to eliminating brain sequences and coverage for the CISS sequence.

FOV: Small FOV for the thin skull base section sequences:

Axial: From optic chiasm through submandibular glands

Sagittal: Skin to skin including entire parotid glands not ears

Coronal: From chin to anterior aspect of brainstem

Sag T1

Ax Diffusion

Ax FLAIR

Ax T2

Ax CISS skull base

Ax T2 fat sat thin skull base or Ax STIR thin skull base

Ax T1 thin skull base

Cor T1 fat sat skull base

Ax T1 fat sat post thin skull base

Cor T1 fat sat post thin skull base

Sag MPR post thru brain


Cranial Nerve w/o contrast:

Use: Perineural spread of tumor, skull based tumors

Consult Radiologist with regards to eliminating brain sequences and coverage for the CISS sequence.

Only to be used if there is a strong contraindication for contrast.

FOV: Small FOV for the thin skull base section sequences:

Axial: From optic chiasm through submandibular glands

Sagittal: Skin to skin including entire parotid glands, not ears

Coronal: From chin to anterior aspect of brainstem

Sag T1

Ax Diffusion

Ax FLAIR

Ax T2

Ax CISS skull base

Ax T2 fat sat thin skull base or Ax STIR thin skull base

Ax T1 thin skull base

Cor T1 fat sat skull base

Sag MPR thru brain


Pituitary Endocrine w/contrast:

Use: Endocrine dysfunction, looking for pituitary microadenoma

Dynamic post contrast: 6 to 8 coronal images through entire pituitary gland (~20 to 30 sec) starting at time of injection for a total of 6 sets of images.

Sag T1 (Sag MPR for pediatrics)

Ax Diffusion

Ax T2

Ax FLAIR

Sag T2 thin thru sella

Cor T1 thin thru sella

Cor T1 thin dynamic post thru sella

Cor T1 thin post thru sella

Sag T1 MPR post thru brain


Pituitary Endocrine w/o contrast:

Use: Endocrine dysfunction, looking for pituitary microadenoma only if there is a strong contraindication for contrast.

Sag T1

Ax Diffusion

Ax T2

Ax FLAIR

Sag T2 thin thru sella

Cor T1 thin thru sella

Sag T1 MPR thru brain


Pituitary Mass w/contrast:

Use: Pituitary mass other than microadenoma

Sag T1 (Sag MPR for peds)

Ax Diffusion

Ax T2

Ax FLAIR

Sag T2 thin thru sella

Cor T1 thin thru sella

Sag T1 thin thru sella

Cor T1 post thin thru sella

Sag T1 post thin thru sella

Sag T1 MPR post thru brain


Pituitary Mass w/o contrast:

Use: Pituitary mass other than microadenoma

Only if there is a strong contraindication for contrast.

Sag T1 (Sag MPR for peds)

Ax Diffusion

Ax T2

Ax FLAIR

Sag T2 thin thru sella

Cor T1 thin thru sella

Sag T1 MPR post thru brain


Orbits/Head w/ contrast:

Sag T1

Ax Diffusion

Ax FLAIR

Ax T2

Cor T2 fat sat from anterior globe thru optic chiasm

Ax T1 thru orbits

Cor T1 fat sat from anterior globe thru optic chiasm

Ax T1 fat sat post thru orbits

Cor T1 fat sat post from anterior globe thru optic chiasm

Sag MPR post thru brain


Orbits/Head w/o contrast:

Use: Only if there is a strong contraindication for contrast.

Sag T1

Ax Diffusion

Ax FLAIR

Ax T2

Cor T2 fat sat from anterior globe thru optic chiasm

Ax T1 thru orbits

Cor T1 fat sat from anterior globe thru optic chiasm

Sag MPR thru brain


General Neck w/contrast:

Coverage: Axials from orbits through lung apices.

If for hoarseness, must go through the entire aortic arch.

Cor T1

Cor STIR

Sag T1

Ax T2 fat sat

Ax T1

Ax Diffusion

Ax T1 fat sat pre

Ax T1 fat sat post

Cor T1 fat sat post


General Neck w/o contrast:

Coverage: Axials from orbits through lung apices. If for hoarseness, must go through the entire aortic arch.

Use: Only if there is a strong contraindication for contrast.

Cor T1

Cor STIR

Sag T1

Ax T2 fat sat

Ax T1

Ax Diffusion

Ax T1 fat sat pre

Cor T1 fat sat


Brachial Plexus w/contrast:

Comments: Must have had a C-spine MRI with 4-6 weeks prior to brachial plexus MRI

Cor STIR both sides

Cor T1 side of interest

Sag T1 side of interest

Sag T1 fat sat or STIR side of interest

Cor T1 post fat sat side of interest

Sag T1 post fat sat side of interest

Cor CISS:

Coverage for CISS: C5 to T2. May have to be done in 2 stacks.

FOV for CISS: Centered over cord. Very small FOV to see nerve roots exit cord and enter neural foramen. There needs to be enough slices to cover the entire spinal canal and a small enough FOV to only cover transverse processes.


Brachial Plexus w/o contrast:

Use: Only if there is a strong contraindication for contrast.

Cor STIR both sides

Cor T1 side of interest

Sag T1 side of interest

Sag T1 fat sat or STIR side of interest

Cor CISS:

Coverage for CISS: C5 to T2. May have to be done in 2 stacks.

FOV for CISS: Centered over cord. Very small FOV to see nerve roots exit cord and enter neural foramen. There needs to be enough slices to cover the entire spinal canal and a small enough FOV to only cover transverse processes.