Week 10: Pelvis

Question 1

What is the patient positioning for all pelvic MRI exams?

Answer 1

Supine, feet first

Question 2

All pelvic exams in MRI require the patient’s mid-sagittal line to be perpendicular to the alignment light. True or false?

Answer 2

True

Question 3

What landmark is used for both male and female MRI pelvis?

Answer 3

1” above the pubic symphysis

Question 4

The landmark used for MRI hamstring depends on the exam’s focus. What landmark is used for a proximal hamstring? Distal?

Answer 4

1. Pubic symphysis
2. Mid-thigh

Question 5

What coil can be used for all exams of the pelvis?

Answer 5

8 channel cardiac coil

Question 6

MRI Male Pelvis can sometimes use a linear shaped coil inserted into the rectum to provide increase signal near the prostate. What is this coil called?

Answer 6

Endo-rectal coil

Question 7

Which of the 3 pelvic exams does NOT generally utilize IV contrast?

Answer 7

MRI Hamstring

Question 8

Normal protocol for MRI Hamstring scans bilaterally, covering from above the _______ down to below the ________.

Answer 8

1. Ischium
2. Knee

Question 9

What sequence options are utilized during MRI male and female pelvis?

Answer 9

1. Flow compensation on
2. No phase wrap on
3. Saturation bands

Question 10

What are the protocols for MRI Hamstring?

Answer 10

1. 3 plane localizer Haste/SSFSE
2. Axial* (T1, T2, PD)
3. Coronal* (IR, T2 Fat Sat, Ideal Thin)
4. Axial* (IR, T2 Fat Sat, Ideal Thin)

Question 11

What is the area of coverage for the 3 plane localizer protocol of an MRI hamstring? Is this considered a short or long area of coverage?

Answer 11

1. Hip to knee
2. Long

Question 12

What field of view is used for the 3 plane localizer and coronal protocols of MRI hamstring?

Answer 12

48-50cm

Question 13

The Coronal protocol views the short axis of the hamstring. True or false?

Answer 13

False; long axis

Question 14

The coronal protocol of MRI, hamstring scans from the _______ aspect of the hamstring to the _________.

Answer 14

1. Anterior
2. Posterior

Question 15

The Axial* and Coronal (IR, T2 Fat Sat, Ideal Thin) protocols of MRI hamstring can show tears in the muscle. A tear would have what kind of appearance on these images?

Answer 15

Bright

Question 16

Where are tears most common in the hamstring?

Answer 16

Near the ischium, the hamstring’s origin

Question 17

Inversion recovery images are acquired during an MRI hamstring because they are ideal for showing what?

Answer 17

Edema patterns of possible tears

Question 18

What three muscles make up the hamstring?

Answer 18

1. Semitendinosus
2. Semimembranosus
3. Bicep femoris

Question 19

The hamstring originates just below the posterior knee and attaches at the ischium. True or false?

Answer 19

False; it originates at the ischium and attaches just below posterior knee

Question 20

What are three clinical concerns for MRI hamstring?

Answer 20

1. Wakeboard injuries.
2. Squatting
3. Femoral extension injuries.

Question 21

What are the protocols for MRI Female pelvis?

Answer 21

1. 3 plane localizer
2. Axial
3. Axial T1/T2 LowAbd/Pel
4. Coronal Ideal/IR LowAbd/Pel
5. Uterus Sagittal T2
6. Uterus Coronal-Oblique T2
7. Uterus Axial-Oblique T2
8. Uterus Axial-Oblique SPGR/Flash/T1 FatSat (pre- and post-contrast)

Question 22

The Axial* protocol of MRI Female evaluates for what 4 concerns?

Answer 22

1. Fibroids
2. Endometriosis
3. Heavy bleeding between cycles
4. Pelvic pain

Question 23

The first few protocols of MRI Female and Male are of the lower abdomen and pelvis. What is the recommended slice thickness for these?

Answer 23

5mm

Question 24

The lower abdomen and pelvis protocols of MRI Male and Female recommend a FoV of _________.

Answer 24

32-36cm

Question 25

For both MRI Male and Female, the Axial T1/T2 LowAbd/Pel protocol covers left trochanter to right trochanter, starting below the pubic symphysis and ending above the kidneys. True or false?

Answer 25

True

Question 26

Which protocol of MRI female and male evaluates the presence of lymph node malignancies?

Answer 26

Axial T1/T2 LowAbd/Pel

Question 27

The coronal Ideal/IR of the lower abdomen for male and female covers from the ________ to the _________.

Answer 27

1. Sacrum 2. Pubic symphysis

Question 28

The Sagittal, Coronal-oblique, and Axial-oblique protocols of both the uterus and the prostate are all similar in that they have the same slice thickness and field of view. What are they?

Answer 28

1. 2.5-3.5mm 2. 16-20cm

Question 29

The Sagittal T1/T2 of the ______ actually covers slightly farther than the _______, covering laterally to the mid-hips as opposed to acetabulums.

Answer 29

1. Uterus 2. Prostates

Question 30

Covering rectum to public symphysis, the coronal-oblique protocol of MRI Female is angled until the plane is parallel with the _______.

Answer 30

Uterus

Question 31

Covering from rectum to pubic synthesis, the coronal-oblique protocol of MRI Male is obliqued: How much? In what direction? And off of which plane?

Answer 31

35° anteriorly off of the sagittal plane

Question 32

A coronal-oblique protocol of MRI prostate is obliqued in such a way to view the long axis of what anatomical structure?

Answer 32

The urethra

Question 33

The axial oblique protocol of MRI prostate and uterus is plotted perpendicular to which plane?

Answer 33

Perpendicular to the coronal oblique

Question 34

The ___________ protocol, of both MRI prostate and uterus, covers from the anus up to above the bladder.

Answer 34

Axial oblique

Question 35

For either MRI Prostate or Uterus, which protocol is used with contrast?

Answer 35

Axial-Oblique SPGR/Flash/ T1 Fat Sat

Question 36

Malignancies are normally _________ fed, and show enhancement within the first __________ of injection.

Answer 36

1. Arterially 2. 30 seconds