MCCCD Program Description

Magnetic Resonance Procedure Protocols

Course: ICE269

First Term: 2015 Fall

Lecture 3.0 Credit(s) 3.0 Period(s) 3.0 Load
Subject Type: Occupational
Load Formula: S - Standard Load

Description: Imaging techniques related to the central nervous system (CNS), neck, thorax, musculoskeletal system and abdominopelvic regions. Specific clinical application, available coils and use. Considerations in scan sequences, specific choices in protocols including slice thickness, phase direction, flow compensation, and positioning criteria. Anatomical structures and plane that best demonstrates anatomy. Signal characteristics of normal and abnormal structures.

MCCCD Official Course Competencies
1. Identify the advantage or disadvantages of magnetic resonance imaging (MRI) over traditional methods of diagnosing pathology. (I) 2. Demonstrate knowledge of the coils used in MRI and their specific application. (I, V, VII) 3. Explain the importance of MRI safety as related to patient scanning and protocols. (II) 4. Describe common artifacts that occur during imaging. (III) 5. Describe criteria for selecting imaging windows for different areas of the body (i.e. window width and window level). (III) 6. State tissue signal characteristics of anatomical structures with and without contrast. (III, IV, VII) 7. Describe advantages and disadvantages of axial, sagittal, coronal and oblique images (i.e. what structures are best demonstrated). (III, V-XIII) 8. Describe common pulse sequences used in evaluation of the different areas of the body. (III, V, VII, IX-XIII) 9. Explain the use of contrast media in evaluation of pathology. (IV, IX-XIII) 10. Explain positioning criteria for different areas of the body. (V-XIII) 11. Explain differences in tissue signal characteristics between adult and pediatric examinations. (VII, XIII) 12. Describe considerations in designing an imaging protocol and state the application of protocols in specific situations. (VIII-XIII) 13. Identify differences between adult and pediatric pulse sequences in MRI. (XIII)
MCCCD Official Course Competencies must be coordinated with the content outline so that each major point in the outline serves one or more competencies. MCCCD faculty retains authority in determining the pedagogical approach, methodology, content sequencing, and assessment metrics for student work. Please see individual course syllabi for additional information, including specific course requirements.

MCCCD Official Course Outline
I. Overview of Equipment and Scan Preparation A. Types of MRI Scanners in Use Today B. Previous Exams/Reports C. Room, Equipment, and Patient Preparation 1. Indications for exam (scanner and patient limitations) 2. Verify order 3. Contraindications for exam 4. Contrast or non-contrast study 5. Patient assessment and monitoring a. Patient identification b. Current medications and allergies c. History of present illness d Reactions, complications and treatment 6. Health Insurance Portability and Accountability Act (HIPAA), Protected Health Information (PHI), and Informed Consent 7. Patient Preparation, Education, and Instructions: Pre and Post procedure 8. Documentation of procedure and patient data in appropriate records 9. Standard precautions II. MRI Safety A. Screening Patients, Personnel, and Non-Personnel for MRI Safe, Conditional, and Unsafe Devices and Objects B. Identify MRI Safety Zones C. Static Field (e.g., projectiles) D. Radiofrequency Field (e.g., Thermal Loading, Coil Positioning, Patient Positioning, and Insulation) E. Time-Varying Gradient Magnetic Fields (e.g., Induced Voltages, Auditory Considerations) F. Communication and Monitoring Considerations (e.g., Sedated Patients, Verbal and Visual Contact, Vital Signs) G. Contrast Media Safety (e.g., NSF, Renal Function) H. Other MRI Safety Considerations (e.g., Cryogen Safety, Fire, Medical Emergencies, Laser Alignment Lights) III. Imaging Considerations ? Scan Protocol Parameters A. Coil Types and Application B. Pulse Sequences C. Parameters (Phase/Frequency Direction) D. Flow and Motion Effects E. Motion Reduction Techniques F. Contrast Agents G. Artifacts H. Window Width and Window Level IV. Contrast Media Preparation and/or Administration A. Pre-Administration Requirements 1. Lab values 2. Medication screening 3. Patient history 4. Signed Informed consent 5. The Joint Commission and American College of Radiology (ACR) Patient Safety Practice Guidelines and Standards B. Intravenous (IV) Contrast 1. Venous access a. Venipuncture b. Power ports c. Power PICS d. Power Central lines e. Power dialysis catheters 2. Indications/contraindications 3. Allergic prep protocol 4. Aseptic/Sterile technique 5. Dosages 6. Intravenous (IV) injection parameters/catheters 7. Extravasation 8. Reaction types, levels and treatment 9. Types of power injectors V. Procedural Protocol and Scanning Parameters A. Positioning Criteria - Patient Orientation B. Anatomical Landmarks C. Sagittal, Coronal, Axial D. Anatomy Best Demonstrated E. Slice Thickness F. Patient Information and Identifiers VI. Adapting to Atypical Situations A. Patient Positioning Challenges and Tips B. Scan Time VII. Signal Characteristics A. Proton Density vs.T1-Weighted vs.T2-Weighted of Normal Anatomy B. Spin-Echo versus Gradient-Echo C. Without and with Contrast Agents VIII. Post Procedural Image Processing A. Image Display B. Image Quality C. Exam Completeness D. Networking and Archiving E. Post image Processing IX. Central Nervous System Procedures A. Clinical Indications 1. Vascular disease 2. Trauma 3. Neoplasia 4. Inflammation 5. Anomalies B. Anatomic Locations 1. Brain 2. Neck 3. Spine and spinal cord X. Musculoskeletal System Procedures A. Clinical Indications 1. Degenerative disease 2. Infection / inflammation 3. Vascular 4. Trauma 5. Neoplasia B. Anatomic Locations 1. Hip 2. Knee 3. Ankle and foot 4. Shoulder 5. Elbow 6. Wrist and hand XI. Abdomen and Pelvis Procedures A. Clinical Indications 1. Infection/inflammation 2. Vascular 3. Trauma 4. Neoplasia B. Anatomic Locations 1. Abdomen 2. Retroperitoneum 3. Pelvis, male and female XII. Thoracic Procedures A. Clinical indications 1. Infection/inflammation 2. Vascular 3. Trauma 4. Neoplasia 5. Anomalies B. Anatomic Locations 1. Mediastinum 2. Chest 3. Brachial plexus 4. Neck 5. Breast XIII. Pediatric MRI Procedures A. Clinical Indications 1. Tumor/infections 2. Developmental anomalies, congenital malformations 3. Myelination patterns B. Sedation 1. Age related 2. General anesthesia

MCCCD Governing Board Approval Date: June 16, 2015

All information published is subject to change without notice. Every effort has been made to ensure the accuracy of information presented, but based on the dynamic nature of the curricular process, course and program information is subject to change in order to reflect the most current information available.