MRI - SHOULDER - PATIENT POSITIONING

[@derrickparks9061]

This also helps with setting up the coronal slices by "flattening the supraspinatus tendon. Sometimes that tendon is more than 45 degrees & causes the coronal to flip when setting it up from the axial image.

[@Nguyen_MRI]

True said 👍

[@michelvandijk2745]

True, but it should not flip. A normal shoulder only has a max. of 15 degrees angle from the thorax, more than 45 degrees would be a very odd anatomy 😉.

[@derrickparks9061]

@@michelvandijk2745 Every patient is different (I'm sure you will agree), but I have had a bunch of patients (more than I care to count) where their tendon does exceed 45 & thus the image flips.

[@LLJKotaru]

My Siemens dedicated shoulder coil has a sponge built in that I can unilaterally position to elevate the opposite shoulder of interest. I also found that if you keep the arm on the side of interest supported with sandbags/sponges so its not resting on their stomach, it will also reduce breathing artifact if they are a belly breather.

[@Nguyen_MRI]

Yeah should never rest the arm on the stomach. Rather have it on the side as you mention.any methods to reduce these unwanted artifacts. Thanks for sharing your experience

[@jlc1026]

Yes, I usually have the pts hand by side or on hip with a small weight just as a gentle reminder. I also try to supinate arm but pronate from elbow down for the comfort of the pt

[@markward2767]

​@@jlc1026also keeping the hand supination keeps the rotator cuff tendons tight so you can see the state of tendon fibres . If the hand is pronated or on the stomach the tendons are bundled up and difficult to see partial years.

[@bism_allah]

بارك الله فيك ان شاء الله 🤍

[@abrabr6720]

و إياكم بالمثل يارب

[@fishyKRIMINAL]

I had the same problem and came up with this same remedy

[@amersfoorter82]

I always do this👍

[@Gun1ld]

I use PAT 3 and increase the average by +1 combined with sat pulses to remove any kind of respiratory induced motion artifacts.

[@abrabr6720]

Thank you.

[@sirajahmedsaifi8694]

Very informative video .. kindly make a video on small part joint mri protocol setup and quality and artefacts remedy how to improve thumb mri fingers mri wrist elbow toes in 1.5 tesla.

[@markdiller3217]

Hey Bac love your videos. What software do you use for your video presentations? Is it PowerPoint in this video? Or the software to record on the scanner with the pointer?

[@Nguyen_MRI]

Hi thanks. Just Powerpoint yes. For recording in the scanner it's camtasia.

[@mirelamihaila1884]

Thank you so much, very helpfull.

[@shastriramroop4815]

Would the change in position work for a flex coil also?

[@Nguyen_MRI]

@@shastriramroop4815 sure.

[@hunnymun1]

Hi Bac thank you for a video for motion artifact from heart , how about using phase encoding direction as head to foot instead of R-L...?🤔

[@Nguyen_MRI]

@@hunnymun1 good idea. In the video i also showed the result H-F

[@vinothravi3736]

Very informative. I appreciate your effort .please make video about cardiac MRI and Elastography

[@Nguyen_MRI]

@@vinothravi3736 kzbin.info/www/bejne/r5PQi4V-f69kbaMsi=RW0unF1XJ4nc5kMs

[@suhaimiss7322]

great tips on this routine MSK examinations. I always done this technique just to eliminate the flip of the images especially in coronal oblique. BTW, is it ok to apply saturation band at the chest area?

[@Nguyen_MRI]

Sure. Sat can be used

[@markward2767]

I turn the pillow 90 degrees so its along the z axis. Reduces Claustrophobia, hand ext. Rotated, if the patient finds this uncomfortable raise the hand a bit wuth sine sponges ie flex the elbow and place a small sand bag on their hand for support. Phase H to F with a sat band inferiorly.

[@Nguyen_MRI]

Thanks for sharing your experience ☺️

[@mirelamihaila1884]

Hi. So you elevated the opposite shoulder not the other shoulder with the coil on? 🤔

[@Nguyen_MRI]

@@mirelamihaila1884 hi. The opposite shoulder is tilted a bit as the video shows.

[@mirelamihaila1884]

Thank you so much. I'll definitely try it​@@Nguyen_MRI

[@michelvandijk2745]

The more you turn oblique, the better the end result. You eleminate motion coming from the thorax. Also, the arm of the patiënt should be exorotated. Many MR-physicians make this mistake, because they don't know how to do it (and don't think about patiënt preperation), or they are to scared in doing it, thinking it would not be comfortable for the patiënt. Preperation is key in the end result of your images, always!

[@Nguyen_MRI]

True said 👍

[@lidorganon7585]

I once read that if a problematic patient u can put send bag on his chest. I did it a few times and it worked 😅

[@Nguyen_MRI]

Truly believe it will work yes 👍

[@michalorenc6376]

Hi. It's a pity you didn't show the complete positioning of the patient including the coil.

[@Nguyen_MRI]

@@michalorenc6376 yeah i didnt think of that. But more less routinely positioning but with tilting part as i showed.

[@haminh1714]

I think we should increase phase oversampling which will also help increase image quality

[@Nguyen_MRI]

True, but not these kind of artifacts.

[@indiantiger4550]

Plz make a video on dti plz request

[@Nguyen_MRI]

kzbin.info/www/bejne/gpOakIqvnLyJsJIsi=MhN0MRrQGLRjqFaa

[@aakib_parray1470]

Why shoulder joint is more susceptible to artifacts

[@Nguyen_MRI]

I can't say it's more artifacts in shoulder compared to other organs. Just more challenging due to positioning. Nonetheless, all exams acquired being able to lie still and comfortable.

[@DouglasBoyd-uh8cc]

Would like to share my shoulder technique, the clock faced method. I will be talking on this at the upcoming ARMRIT conference in Oct. Do not want to miss!! Please see my podcast with ZONE 3 on clock face. Thanks for the great info Bac!!!

[@Nguyen_MRI]

Thanks 😊

[@jimt2316]

I feel like I was click baited into only part of the equation. Please provide your complete positioning solution. A more comfortable patient, will always provide better results. IE A knee bolster eases patients low back issues. A knee in the air, on most patients will create motion as it swings freely. What did you do on the left side when that arm dropped? Did you immobilize the hand? Do you really use that much pillow at the head, as it can block airflow for claustrophobic patients.

[@Nguyen_MRI]

Sadly you felt it was clickbait. Was not my intention. A soft pillow between the knees. The right arm on the stomach. I was more focused on the tilting part so didn't think through the other parts. Also yes we so use pillow but I also heard and recommend to use something less due to airflow as you say. Haven't got any issues on the sar nor claustrophobic both on 1.5T and 3T. 60cm vs 70cm.

[@Nguyen_MRI]

And with this video it's not meant to ; this is the truly solution for everything. It's rather a tips to adapt if finding it useful.

[@iggyantioch]

This works. I had a colleague show me something similar. I am going to combine yours and his. Thanks for the video!