Indications for knee MRI scan

> Meniscal disorders: nondisplaced and displaced tears, discoid menisci, meniscal cysts
> Marrow abnormalities: avascular necrosis, marrow edema syndromes, and stress fractures
> Congenital and developmental conditions: blount disease, dysplasia, normal variants
> Synovial based disorders: symptomatic plicae, synovitis ,bursitis, and popliteal cysts
> Muscle and tendon disorders: strains, partial and complete tears, tendonitis, tendonopathy.
> Mechanical knee symptoms: catching, locking, snapping, crepitus
> Vascular conditions: entrapment, aneurysm, stenosis, occlusion
> Neoplasms of bone, joint or soft tissue
> Infections of bone, joint or soft tissue
> Ligament tears: cruciate, collateral, retinacular
> Osteochondral and articular cartilage infractions
> Osteochondral fractures
> Osteochondritis
> Degenerative chondrosis
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> Degenerative chondrosis

> Chondromalacia
> Acute trauma
> Fractures

Contraindications
> Any electrically, magnetically or mechanically activated implant (e.g. cardiac pacemaker, insulin
pump biostimulator, neurostimulator, cochlear implant, and hearing aids)
> Intracranial aneurysm clips (unless made of titanium)
> Pregnancy (risk vs benefit ratio to be assessed)
> Ferromagnetic surgical clips or staples
> Metallic foreign body in the eye
> Metal shrapnel or bullet

Patient preparation
> A satisfactory written consent form must be taken from the patient before entering the scanner
room
> Ask the patient to remove all metal objects including keys, coins, wallet, cards with magnetic
strips, jewellery, hearing aid and hairpins
> If possible provide a chaperone for claustrophobic patients (e.g. relative or staff )
> Offer earplugs or headphones, possibly with music for extra comfort
> Explain the procedure to the patient
> Instruct the patient to keep still
> Note the weight of the patient

Mould Testing Laboratory

Fast Lab Results Canada and US Labs

Positioning
> Feet first supine
> Position the knee in the knee coil and immobilise with cushions
> Give cushions under the ankle for extra comfort
> Centre the laser beam localiser over the lower border of patella
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> Centre the laser beam localiser over the lower border of patella

Suggested protocols, parameters and planning

localiser
A three plane localiser must be taken in the beginning to localise and plan the sequences. Localisers
are usually less than 25sec. T1 weighted low resolution scans.

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PD fat sat axial 4mm

Plan the axial slices on the coronal plane; angle the position block parallel to the medial and lateral
condyle of the femur. Check the positioning block in the other two planes. An appropriate angle
must be given in sagittal plane (perpendicular to the line of femur and tibia). Slices must be sufficient
to cover the knee joint from the tibial tuberosity up to the line of superior border of patella. Phase
direction in the axial scans must be right to left, this is to avoid the artifacts form popliteal artery
pulsation. Using saturation bands above and below the axial block will reduce further arterial
pulsation artefacts.

Parameters
TR

TE

3000-4000 15-20

SLICE

FLIP

PHASE MATRIX FOV

4 MM

130-150 R>L

GAP

320X256 150-160 10%

NXA(AVRAGE)
2

PD fat sat coronal 4mm

Plan the coronal slices on the axial plane; angle the position block parallel to the medial and lateral
condyle of the femur. Check the positioning block in the other two planes. An appropriate angle
must be given in sagittal plane (parallel to the mid line line of femur and tibia). Slices must be
sufficient to cover the knee joint from the pattela down to the line of popliteal artery. Phase
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sufficient to cover the knee joint from the pattela down to the line of popliteal artery. Phase
direction in the axial scans must be head to feet, this is to avoid the artifacts form popliteal artery
pulsation. Using saturation bands above and below the coronal block will reduce further arterial
pulsation artefacts.

Parameters

TR

TE

3000-4000 15-20

SLICE

FLIP

PHASE MATRIX FOV

4 MM

130-150 R>L

GAP

320X256 160-170 10%

NXA(AVRAGE)
2

Testing Laboratory
Microbiology - Air Quality - Mold Asbestos - Environmental - Lead Go
to emsl.com

T1 tse sagittal
Plan the sagittal slices on the axial plane; angle the position block parallel to the lateral condyle of
the femur(parallel to anterior cruciate ligament). Check the positioning block in the other two
planes. An appropriate angle must be given in coronal plane (parallel to the mid line of femur and
tibia). Slices must be sufficient to cover the knee joint from the lateral condyle up to medial condyle.
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tibia). Slices must be sufficient to cover the knee joint from the lateral condyle up to medial condyle.
Phase direction in the axial scans must be head to feet, this is to avoid the artifacts form popliteal
artery pulsation. Using saturation bands above and below the sagittal block will reduce further
arterial pulsation artefacts.

Parameters

TR

TE

SLICE

FLIP

PHASE MATRIX FOV

400-600

15-25

3 MM

130

H>F

GAP

320X320 160-170 10%

NXA(AVRAGE)
2

T2 STIR sagittal
Plan the sagittal slices on the axial plane; angle the position block parallel to the lateral condyle of
the femur(parallel to anterior cruciate ligament). Check the positioning block in the other two
planes. An appropriate angle must be given in coronal plane (parallel to the mid line of femur and
tibia). Slices must be sufficient to cover the knee joint from the lateral condyle up to medial condyle.
Phase direction in the axial scans must be head to feet, this is to avoid the artifacts form popliteal
artery pulsation. Using saturation bands above and below the sagittal block will reduce further
arterial pulsation artefacts.

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Parameters

TR

TE

FLIP NXA SLICE MATRIX FOV

4000-5000

110 130

4MM

256X256

160-170

PHASE

GAP

TI

H>F

10%

130

T2*(MEDIC) sagittal
Plan the sagittal slices on the axial plane; angle the position block parallel to the lateral condyle of
the femur(parallel to ACL). Check the positioning block in the other two planes. An appropriate
angle must be given in coronal plane (parallel to the mid line of femur and tibia). Slices must be
sufficient to cover the knee joint from the lateral condyle up to medial condyle. Phase direction in
the axial scans must be head to feet, this is to avoid the artifacts form popliteal artery pulsation. Using
saturation bands above and below the sagittal block will reduce further arterial pulsation artefacts.

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Parameters

TR

TE

FLIP NXA SLICE MATRIX FOV

800-1200

15-25 30

4 MM

320X256

160-170

PHASE

GAP

oversample

H>F

10%

50%

CLICK THE SEQUENCES BELOW TO CHECK THE SCANS

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