0:01

All right.

0:01

Obviously, in addition to T2-weighted sequences,

0:03

you want to do T1-weighted sequences for enterography.

0:06

These are as important, if not

0:08

more important, than the T2 series.

0:10

And getting high-quality images here, both pre

0:14

and post-contrast, is going to be really helpful.

0:17

Generally, the majority of these are done in

0:18

the coronal plane, and that's because you can

0:21

get good coverage in a relatively good time

0:23

and see the whole picture regarding the bowel

0:26

in the coronal plane.

0:27

So when you do your dynamic sequences,

0:29

you want to do them in the coronal plane.

0:31

Now we do this a pre-contrast series and then

0:34

we do one at arterial phase, more or less.

0:37

So somewhere in that 30 to 45

0:39

second range is about right.

0:41

And then repeat that at least two

0:43

times at 45-second intervals.

0:47

And then optionally, you can do a delayed phase.

0:50

So for our T1-weighted sequences, we do the 3D

0:54

VIBE sequence using Siemens, and now that's a

0:56

RF-spoiled 3D GRE sequence, and similar to the

0:59

VIBE, LAVA, THRIVE sequences with other vendors.

1:03

If you want to make sure you include the

1:05

whole picture here, from the liver down

1:07

through the anus, at least to the anus,

1:10

if not through the anus, on your coronal plane.

1:12

So that's our pre-contrast image.

1:13

We do the exact same field of view

1:15

on our post-contrast coronals.

1:17

This one's maybe a little higher than it needs to

1:19

be, but you’ve got to get at least through the liver.

1:21

And at the 45 seconds, this will give you a

1:25

good marker for the early enhancement, which

1:27

we'll get into later, the importance of that.

1:29

Then we go again in more of a portal venous phase.

1:32

So more of a 90 seconds, more or less

1:36

series here

1:37

And at this point, this looks like what you

1:39

typically see as a good sequence for evaluating

1:42

the remainder of the abdomen as far as the

1:44

liver, kidneys, spleen, and other parts of the

1:46

abdomen that you expect to see at this time point

1:50

with a relatively normal enhancement pattern.

1:52

And then you want to do at least one more series.

1:55

Now, for our 90-second image, we actually do this

1:59

in the axial plane, and I think doing at least

2:00

one version in the axial plane is important.

2:03

And so, we go all the way from the abdomen near the

2:07

top of the liver all the way almost to the bottom

2:09

of the anus in one breath hold here for this

2:13

axial series, and there will be times when

2:15

the axial series will be super helpful.

2:16

So I would do at least one at 90 seconds or at

2:20

120 seconds, more or less, in the axial plane.

2:24

Lastly, we do 7-minute imaging.

2:27

So we do this coronal and axial.

2:30

You can probably do it just coronal;

2:32

that would be totally fine.

2:34

And we'll get into why we do 7-minute

2:36

imaging, but this can help you

2:38

differentiate fibrosis from early enhancement.

2:42

This is more of an optional series.

2:44

The other ones I have shown so far are pretty

2:46

much required elements of enterography,

2:48

but the seven-minute I find helpful, though

2:51

it's a little more of an optional sequence.