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myBSPR.org

MRI in Brain Tumours

Guidelines for MRI in Paediatric Brain Tumours

This protocol is amended from:- Clinical Radiology, 

September 1999,54(9);558-562

SUPRATENTORIAL TUMOURS


At Presentation

Sequences:

Cranial

Axial dual echo SE (spin echo) or FSE (fast spin echo)

Coronal T1 SE

Post contrast (i.v. gadolinium DTPA) T1 SE in at least two orthogonal planes.


Spinal


Post contrast whole spine sagittal T1 SE Axial T1 SE if equivocal


Guideline parameters:

Cranial:- Slice thickness <5 mm

FOV (field of view) 180-230 em

Matrix <256x256 (effective)

T1 SE

TR:<800 msec.

TE: <25 msec

T2 SE

TR:2,000-2,600 msec,

TE:20/90 msec

T2 FSE

TR:3,000-4,000 msec,

TE:20/90 msec

Spinal:- T1 SE TR: <600 msec

TE: <25 msec

Slice thickness <4 mm

Contrast medium: i.v. line to be placed prior to attending MR department where possible. I.V. Gadolinium DTPA 0.1 mmol/kg


Immediate Post Surgery - (Assessment of Residual Tumour)

Timing: Within 72 hr

Sequences:

Cranial:- Coronal Tl SE

Axial dual echo SE/FSE

Post-contrast T1 SE in at least two orthogonal planes

Spinal:- Not recommended, see text

Parameters and contrast medium:- as above


Late Follow-up MRI

Timing:- Protocol driven - dependent on tumour type

Sequences:-

Cranial:- Coronal TI SE

Axial dual echo SE/FSE

Post-contrast TI SE in at least two orthogonal planes

Spine:- Post-contrast whole spine sagittal TI SE (If histology indicates tumour type with potential to seed through the CSF).

Parameters, contrast medium:- As before

-----------------------------------------------------------------------


INFRATENTORIAL TUMOURS

Presentation


Sequences:-

Cranial:- Whole brain axial coronal TI SE

Whole brain T2 SE/FSE axial

Sagittal T2 through brainstem for brain stem glioma

Post-contrast T 1 SE in at least two orthogonal planes

Spinal:- Post-contrast whole spine sagittal T1 SE

Parameters:- As for supratentorial lesions

Slice thickness <5 mm

Contrast medium:- i.v. line to be placed prior to attending MR department, when possible. I.V. Gadolinium DTPA 0.1 mmol/Kg.


Immediately Post-surgery -Assessment of Residual Tumour

Timing:- Within 72 hr

Sequences:-

Cranial:- Whole brain coronal T1 SE

Axial T2 SE/FSE

Post contrast T 1 SE in two orthogonal planes

Spinal:- Not recommended, see text

Parameters, contrast medium:- As before


Late Follow-up MRI


Parameters: As before

Timing:- Protocol driven (dependent on tumour type)

Sequence:-

Cranial:- Whole brain coronal T1 SE

Whole brain axial T2 SE/FSE Post contrast

T1 SE in two orthogonal planes

Spinal:- Post contrast sagittal T1 SE

Contrast medium:- As before


Abbreviations

FSE - Fast Spin Echo

SE - Spin Echo

TE - Time to Echo

TR - Time to Repeat

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