This document provides guidance on performing MRI of the lower limb, including the hip, femur, tibia/fibula, ankle, and foot. It outlines the typical indications, equipment, positioning, and imaging sequences for each anatomical area. Key details include using spine coils for the hip and distal lower limb, body arrays for the femur and tibia/fibula, and extremities coils for the ankle and foot. Imaging planes include coronal, sagittal, and axial with T1, T2, STIR, PD and FS sequences. Slice thickness and orientation varies depending on the specific anatomical area being imaged.
This document provides guidance on performing MRI of the lower limb, including the hip, femur, tibia/fibula, ankle, and foot. It outlines the typical indications, equipment, positioning, and imaging sequences for each anatomical area. Key details include using spine coils for the hip and distal lower limb, body arrays for the femur and tibia/fibula, and extremities coils for the ankle and foot. Imaging planes include coronal, sagittal, and axial with T1, T2, STIR, PD and FS sequences. Slice thickness and orientation varies depending on the specific anatomical area being imaged.
This document provides guidance on performing MRI of the lower limb, including the hip, femur, tibia/fibula, ankle, and foot. It outlines the typical indications, equipment, positioning, and imaging sequences for each anatomical area. Key details include using spine coils for the hip and distal lower limb, body arrays for the femur and tibia/fibula, and extremities coils for the ankle and foot. Imaging planes include coronal, sagittal, and axial with T1, T2, STIR, PD and FS sequences. Slice thickness and orientation varies depending on the specific anatomical area being imaged.
This document provides guidance on performing MRI of the lower limb, including the hip, femur, tibia/fibula, ankle, and foot. It outlines the typical indications, equipment, positioning, and imaging sequences for each anatomical area. Key details include using spine coils for the hip and distal lower limb, body arrays for the femur and tibia/fibula, and extremities coils for the ankle and foot. Imaging planes include coronal, sagittal, and axial with T1, T2, STIR, PD and FS sequences. Slice thickness and orientation varies depending on the specific anatomical area being imaged.
Indication • Loose body • Tumors • Tumors • Tendonitis • Tumor • Unexplained hip pain; e.g.: • Infection • Infection • Achilles tendon • Infection AVN, mets. • Muscle tear • Muscle tear rupture • Bone trauma • Suspected occult #. • AVN of talus • Muscle tears. • Evaluation of lateral • Soft tissue pathology. ligament complex Equipment • Spine coil (post) and • Spine coil (post) and • Spine coil (post) and • Knee coil • Extremity coil/head • Bilateral: Body coil/body • Body array coil (ant) • Body array coil (ant) • Immobilization pads coil phased array (ant) • Immobilization pads • Immobilization pads & straps • Immobilization pads • Unilateral: Small/large flex & straps & straps • Ear plugs & straps coil (ant) • Ear plugs • Ear plugs • Ear plugs • Immobilization pads & straps • Ear plugs Positioning • Supine; head first • Supine; head first • Supine; feet first • Supine • Supine • Legs straight • Legs straight • Legs straight • Foot & ankle within • Foot & ankle within • Feet parallel to each other • Feet parallel to each • Feet parallel to each knee coil the coil • Immobilized & straps both other other • Dorsiflex foot • Dorsiflex foot feet • Immobilized & straps • Immobilized & straps • Elevate foot & ankle • Elevate foot & ankle • Longitudinal light: midline both feet both feet • Longitudinal light: • Longitudinal light: • Horizontal light: level of • Longitudinal light: • Longitudinal light: midline midline femoral heads midline midline • Horizontal light: • Horizontal light: level • Horizontal light: • Horizontal light: level malleoli of of ROI midpoint of femur/ midpoint of tib fib/ interest over ROI over ROI *unilateral: offset ROI as *unilateral: offset ROI as closed as possible to closed as possible to isocenter isocenter *palace oil-or water *palace oil-or water filled filled marker (e.g.: fish marker (e.g.: fish oil oil capsule) over capsule) over palpable palpable lesion lesion Sequences • Cor FSE T2 + FS/STIR: • Sag STIR: • Cor SE T1: • Ax SE T1: • Ax SE T1: Thin slices Medium slices As diagnostic seq To evaluate tendon To evaluate tarsal Frm post-ant margin Slice orientation: Medium slices of ankle, & metatarsal of musculature of hip parallel to long axis Frm post-ant aspect vasculature, nerves curvature of femur of lower legs; whole Thin slices To provide clear • Cor SE T1 (as above) tib fib Frm origin if anatomical • Cor SE T1: Achilles tendon to structures • Ax SE T1: Medium slices • Cor/Sag STIR: bottom of Thin slices Thin slices Frm ant-post skin Medium slices calcaneum Frm end of toe to Above articulator surface; entire Slice orientation tarsal bones portion of acetabulum femur along line of leg • Ax FSE PD/T2 +FS to sup edge of lesser Slice orientation: Frm post-ant of calf; Similar to Ax SE T1 • Ax FSE PD/T2 + FS: trochanter parallel to long axis whole legs Useful to classify Demo jt effusion, to femur tendon injury & mass lesion & • Cor SE T1 identify jt effusions collections • Ax SE T1: Medium slices FS useful to demo FS enables Use to to localize Slice orientation subtle trabecular visualization of lesions along line of leg damage & cartilage subtle trabecular Medium slices Frm post-ant of calf; damage in stress # Cover the entire whole legs of metatarsal lesion seen on cor bones & sag images • Ax SE T1: Thin slices Useful to localize Frm end of toe to • Ax FSE T2 + FS: lesions tarsal bones • Sag FSE T2 +FS Use to to localize Medium slices To demo flattening of lesions Frm above & below femoral head Medium slices lesion seen in sag & associated with AVN Cover the entire cor planes • Sag SE T1/FSE PD Thin slices lesion seen on cor To evaluate tendon Frm lat aspect of & sag images • Ax FSE T2+FS (as Ax & bony component greater trochanter SE T1) of ankle through the articular Thin slices potions of acetabulum Frm lat – med of ankle; whole foot & ankle
• Sag FSE T2 +FS/ STIR
Similar to Sag T1 Useful to demo jt effusion tendonopathy & • Sag SE T1: calcaneal or tarsal # Thin slices Frm lat to medial of • Cor SE T1/FSE PD/T2 foot; frm sole of +FS foot to distal tibia To demo collateral • Sag FSE PD/STIR /T2 + ligaments FS: To visualize distal Thin slices portion of post Lat to med of foot ; tibialis tendon frm sole to distal Thin slices tibia Frm Achilles tendon to base of prox metatarsal
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