MR Urogram W/WO Protocol

Scan Notes

Last updated: 10/2/2023
Charge as: Abdomen W/WO
Scanner: MR4 only (Adults)
Coil: Torso Coil 
Scan time: approximately 1.5 hours

  • This is the adult protocol. For peds patients, follow peds protocol.
  • IV hydration with a saline bolus is ok without the Foley. If the patient does have a Foley, please clamp the Foley.
  • ALL patients should void prior to getting on the table.
  • Cover through the perineum. On axials, cover from the top of kidneys to the bottom of the bladder. Two stacks if needed.
  • Load Power injector with weight-based gad and saline.
  • Call rad to check images before giving Lasix. 
  • Plan the sequences in advance as much as possible so you can appropriately time the Lasix injection. 

ORDERS:  Ordering MD must put in orders in EPIC for IV Lasix and IV saline.

IV HYDRATION (two options):

  • Option 1. IV hydration with a saline bolus is ok without the Foley. If the patient does have a Foley, please clamp the Foley.
  • Option 2. IV hydration for one hour before study with normal saline 4 cc/kg/hr for first 10 kg of body weight, 2 cc/kg/hr for next 10 kg of weight, and 1 cc/kg/hr for each additional kg of weight. 
  • ALL patients should void prior to getting on the table. 

IV LASIX:

  • RN to inject Lasix.
  • Dosage = 0.5 mg/kg, max 20 mg. IV Lasix is given approximately 15 minutes before MR contrast. 
  • Outpatients: Lasix is kept in MRI. 
  • Inpatients: Lasix is ordered from the pharmacy.

CONTRAST INJECTION:

  • Call rad to check images before giving contrast. Ask if they want to see the images before the patient gets off the table.
  • Check the Dynamic tab on scanner: “Continuous scanning” for the first 5 minutes, and then 1 dynamic every 10 seconds.

  • Inject contrast @ 0.1ml/sec with power injector.
  • Start scan and inject gad at the same time.
  • This sequence is 20 minutes long. Once the scanner has completed running the first 5 minutes of continuous scanning it will pause and then will automatically start again for the timed delays. Don’t worry that the scanner has stopped as it’s just a timed sequence with long pauses built in. Do not stop the scan.
MR Urogram WWO Protocol image
Plane Weighting Mode Slice Gap FAT SAT FOV Notes
AXIAL T1 TFE 5mm 1mm None Fit to Patient Cover from the top of kidneys to the bottom of the bladder. Two stacks if needed.
AXIAL T2 TSE MV MS 5mm 1mm SPIR Fit to Patient Cover from the top of kidneys to the bottom of the bladder. Two stacks if needed.
RAD TO CHECK IMAGES
RN injects Lasix
SAG T2 TSE MV MS 5mm 1mm SPIR Fit to Patient Entire abdomen and perineum, skin to skin.
COR T1 TFE 5mm 1mm None Fit to Patient Entire abdomen and perineum, skin to skin.
COR T2 TSE 5mm 1mm SPIR Fit to Patient Entire abdomen and perineum, skin to skin.
COR T2 THICK SLAB MRCP WITH MIP Angle as shown below to include the kidneys and bladder.
COR post Lasix T2 TSE 5mm 1mm SPIR Fit to Patient Entire abdomen and perineum, skin to skin.
RAD TO CHECK IMAGES
Contrast Injection
Power inject contrast @ 0.1ml/sec. Start scan and inject gad at the same time.
Cor Obl Dynamic FFE Dynamic (See above notes about injection) Through kidneys and ureters. Include bladder. Don't change the FOV of this sequence unless the patient truly doesn't fit. If you have to change the FOV, you must check the dynamic timing to ensure it hasn't altered. If it's changed, you will need to manually adjust all of the dynamics.
COR T1 TFE 5mm 1mm SPIR Fit to Patient Same as Pre
AXIAL T1 TFE 5mm 1mm SPIR Fit to Patient Same as Pre
COR mDixon FFE 2mm 1mm None Fit to Patient Same as Pre