Date Created: 1.15.2020
MR Urography
A) Preparation or initial instructions:
- Sedation/anesthesia-‐ usually < 7 years of age
- Non-‐sedate cases NPO 4 hours prior to scan
- Hydration-‐ 20cc/kg bolus prior to imaging
- Bladder Catheterization-‐ Foley catheter without balloon connected to a bag which is placed below the level of the table to facilitate bladder emptying
- Procedural meds-‐ Lasix 1mg/kg (max 20 mg) given 15 min before IV gadolinium injection
- Positioning: Prone (unless precluded by surgery, sedation issues etc…
- Coverage-‐ from diaphragm to below the bladder, A-‐P coverage through the kidneys
B) Protocol table:
Sequence Name
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Vendor Specific name
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Plane
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Fat suppression
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Motion compensation
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Other relevant parameters
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Additional info
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1. T2Single Shot (2D)
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T2 HASTE, SSFSE, sSH-TSE
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Sagittal and axial
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No
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FB or BH based on patient age
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Essential for planning oblique coronals
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2. T2 (2D)
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BLADE, PROPELLER, MultiVane
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Axial (abdomen)
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Yes
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FB
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Depicts scarring, dysplasia well
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3. T2 (3D)
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T2 SPACE/CUBE/VISTA
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Coronal (isotropic)
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Yes
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RT or navigator
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Can use to reconstruct in other planes
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4. T1 (3D)
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VIBE/THRIVE/LAVA
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Coronal
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Yes
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FB
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Fast Scan
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Pre-contrast oblique to include kidneys, ureters and bladder
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5. T1 (3D) post contrast
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VIBE, LAVA, THRIVE
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Coronal
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Yes
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FB
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Repeated till contrast in ureters or for 8 min
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Can be repeated, same oblique plane as pre- contrast
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Optional Sequences
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6. DWI axial b-value ( 2-3 b values)
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Axial
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7. T2 SSFSE
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T2 HASTE, SSFSE, sSH-TSE
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Coronal
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No
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FB or BH based on patient age
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8. T2
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Axial
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Yes
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High resolution imaging through pelvis
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Concern for ectopic ureter
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9. T1 (3D)
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VIBE, LAVA, THRIVE
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Coronal and Sagittal
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Yes
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FB
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Concern for calyceal diverticulum
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10. Coronal cinematic balanced SSFP
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TruFISP/FIESTA/balanced FFE
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Coronal
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Yes
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RT,BH
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Concern for fibroepithelial polyp
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BH =Breath-hold; FB = Free Breathing; RT = Respiratory Triggered; sSH = single-shot; T/FSE = Turbo/Fast Spin-echo
C) References: