0:01

All right, so the next T2 sequence that we're

0:03

going to review is the T2 with fat saturation.

0:06

So in addition to the axial and coronal

0:09

images without fat saturation,

0:10

we perform a coronal with fat saturation.

0:13

We don't repeat that in the axial plane because I think

0:15

that's redundant and probably not needed, but you do

0:17

want to get a fat-saturated image in one of the planes.

0:21

The main reason for including this in addition to

0:23

the non-fat-saturated images is to really bring

0:26

out any areas of inflammation or areas of edema.

0:28

13 00:00:29,580 --> 00:00:31,260 So this is a fairly normal exam, and we

0:31

don't have a lot of inflammation or edema.

0:34

And what you'll see with this fat-saturated sequence

0:36

is that if there was, the, the wall of the bowel

0:40

would be brighter than the adjacent fat and muscle.

0:43

And so looking for edema, you can't

0:46

beat the fat-saturated sequence.

0:48

Another advantage is that sometimes with

0:51

chronic inflammation, we'll actually

0:52

get fat within the wall of the bowel.

0:54

And so you need the fat-saturated

0:56

sequence to differentiate

0:58

those T2 images that have fat in the wall versus

1:01

the ones that have true edema in the wall.

1:05

And so that's the main use for this, and you

1:06

use it in conjunction with the coronal T2

1:09

images without fat saturation to help you.

1:12

The other T2 type sequence that we do is the true

1:15

FISP sequence or steady-state free precession.

1:19

So this is a... we use MRI.

1:22

So it's a true FISP, but certainly

1:24

Fiesta for GE and Phillips has a similar

1:26

sequence, depending on your vendor.

1:28

For this sequence, the main advantages are

1:33

it's so fast that you don't have that

1:35

same problem with the intraluminal defects.

1:39

And so as you look through this bowel,

1:41

what you see is that it's all very well

1:43

pacified, except for these areas, which are

1:45

air in the bowel.

1:46

Of course, with the prone patient,

1:48

it's on the anti-dependent side.

1:50

So it's on the, on the, towards the sacrum.

1:53

But other than that, everything in this

1:54

is a true bowel intraluminal defect.

1:58

If you have a patient with Kutzinger's or

2:00

something where you're looking for masses,

2:03

the True FISP sequence ends up being one of the most

2:05

critical sequences because it's much better

2:08

at finding things in the lumen of the bowel.

2:11

And we do this in two planes.

2:12

We do it axial and coronal.

2:14

It may not be necessary, but it's such a

2:16

fast sequence and you give up so little by

2:19

doing it that I would recommend doing that.

2:22

Another advantage is sometimes patients with

2:25

motion or patients where the bowel peristalsis is not

2:28

great from the glucagon or whatever antiperistaltic

2:31

you give, the True FISP will still turn out

2:33

wonderful because it's such a fast sequence, even

2:36

though your T2 sequences may not be as strong.

2:40

All right, so that's it for T2 sequences, and now

2:42

we'll move on to some of the other pieces of the exam.