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MR Enterography

Jump to: Indications | Scheduling | Patient Prep | Billing | ICD9 Codes | Sample Report | Download

Protocol Name = MR Enterography
Entry = Feet First
Position = Supine
Coil = 8Ch Body FullFOV
Series number = 16

Series Notes Pulse Sequence Mode Imaging Options Plane FOV Thickness Spacing Frequency Phase TR TE Flip Angle
3-pl SSSFE Spin Echo 2D Seq, Fast, SS 3-PLANE 48.0 8.0 0.0 384 224 Minimum 160.0
Calibration scan BH NEW FULL Gradient Echo 2D Fast, Calib AXIAL 48.0 15.0 0.0
Calibration scan BH NEW UPPER Gradient Echo 2D Fast, Calib AXIAL 48.0 15.0 0.0
Calibration scan BH NEW UPPER Gradient Echo 2D Fast, Calib AXIAL 48.0 15.0 0.0
COR T2 SSFSE ABD AND PEL Spin Echo 2D Fast, SS, Asset OBLIQUE 44.0 5.0 0.0 384 224 Minimum 90.0
Ax T2 SSFSE ABD Spin Echo 2D Fast, SS, Asset AXIAL 40.0 8.0 0.0 384 224 Minimum 90.0
Ax T2 SSFSE PELVIS Spin Echo 2D Fast, SS, Asset AXIAL 40.0 8.0 0.0 384 224 Minimum 90.0
COR 2D FIESTA ABD AND PEL Fiesta 2D Seq, Fast CORONAL 44.0 4.0 0.4 192 320 Min Full 75
AX 2D FIESTA FS ABD Fiesta 2D Seq, Fast AXIAL 38.0 4.0 1.0 224 320 Min Full 70
AX 2D FIESTA FS PEL Fiesta 2D Seq, Fast AXIAL 38.0 4.0 1.0 224 320 Min Full 70
COR T2 FS DYNAMIC Spin Echo 2D Fast, SS OBLIQUE 38.0 70.0 0.0 480 256 6000.0 1392.0
Ax LAVA BH ABDOMEN C- LAVA-XV 3D EDR, Fast, ZIP2, ARC OBLIQUE 40.0 4.4 320 160 12
Ax LAVA BH PELVIS C- LAVA-XV 3D EDR, Fast, ZIP2, ARC OBLIQUE 40.0 4.4 320 160 12
COR LAVA BH MP ABD-PELVIS LAVA-XV 3D EDR, Fast, ZIP512, ZIP2, Fluoro, MPhVar, ARC OBLIQUE 44.0 4.4 224 224 12
Ax LAVA BH ABDOMEN C+ LAVA-XV 3D EDR, Fast, ZIP2, ARC OBLIQUE 40.0 4.4 320 160 12
Ax LAVA BH PELVIS C+ LAVA-XV 3D EDR, Fast, ZIP2, ARC OBLIQUE 40.0 4.4 320 160 12


Overview
Magnetic resonance enterography helps to evaluate any bowel process safely and noninvasively including infectious or inflammatory process (Crohn's disease and ulcerative colitis), typhlitis, short gut as well as neoplastic process without exposing them to ionizing radiation.


Indications
See ICD codes below


Scheduling
First Ask:
1. Why is the MRI being requested?
2. What prior imaging (CT, US) has been done? If prior imaging was performed in another imaging center, please ask for a copy of report and ask patient to bring in films if possible.
3. Have you had prior bowel surgery or procedure? What operation or procedure (colonoscopy, upper endoscopy)?
4. Have you ever had cancer? What type of cancer? When was the cancer diagnosed?
5. Have you ever been diagnosed any bowel disease, such as Crohn's disease, ulcerative colitis, neoplasm, etc?


Patient Preparation
Start IV line (20 or 22 gauge IV). If iv caliber is small (i.e. 22 gauge) then warm the Gd contrast up to body temperature to reduce its viscosity.

Valium (5-10mg po) or Xanax (1-2 mg po) if patient is claustrophobic.

Ear plugs.

Coil: 8 channel body coil.

Patient positioning: Prone (supine if patients cannot tolerate prone positioning), feet first. The arms are positioned comfortably next to abdomen. Patient must have comfortable pillow for head and a cushion under the knees to relieve pressure.

Landmark: Three fingers below the xyphoid at rib cage margin.

* Patient prep
- Bowel prep day before – low residue diet, fluids, laxative.
- Overnight fasting or NPO 4-6 hrs prior to study

* All should get IV contrast (MultiHance) except pregnant patients and those in renal failure. This includes kids and adults.

*** All adults and kids should get 3 bottles of oral contrast (VoLumen (low-conc barium (0.1% weight/volume) that contains sorbitol) - each bottle is 450 ml.


Billing Code



ICD9 Codes
555.0 Crohn's disease of the small intestine
555.1 Crohn's disease of the large intestine
555.9 Crohn's disease, unspecified
558.9 Colitis, unspecified cause
562.11 Diverticulitis of the colon
153.9 Colon cancer
789.02 Abdominal pain, left upper quadrant
789.01 Abdominal pain, right upper quadrant
789.03 Abdominal pain, right lower quadrant


Normal Dictation
Clinical statement
Technique
Findings
Impression


raw scanner file download pdf download .tar

September 2, 2012  Tags: , , , ,   Posted in: MRI, body, body other