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MRI - SHOULDER - PATIENT POSITIONING

  Рет қаралды 7,866

Bac Nguyen

Bac Nguyen

Күн бұрын

Пікірлер: 56
@LLJKotaru
@LLJKotaru 5 ай бұрын
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
@Nguyen_MRI 5 ай бұрын
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
@jlc1026 5 ай бұрын
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
@markward2767 4 ай бұрын
​@@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.
@derrickparks9061
@derrickparks9061 5 ай бұрын
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
@Nguyen_MRI 5 ай бұрын
True said 👍
@michelvandijk2745
@michelvandijk2745 5 ай бұрын
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
@derrickparks9061 5 ай бұрын
@@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.
@Ahaha4
@Ahaha4 Ай бұрын
R-L direction for left shoulder
@Ahaha4
@Ahaha4 Ай бұрын
A-P for right
@mateuszradtech
@mateuszradtech 29 күн бұрын
positioning is very important at all, i always using a lot of sponges to make comfortable patient positions, Shlouders usually are more painful minute after minute during the exam ;) regards from Poland. Amazing channel ! :)
@Nguyen_MRI
@Nguyen_MRI 29 күн бұрын
@@mateuszradtech thanks for the comment and sharing your experience. ☺️
@bism_allah
@bism_allah 5 ай бұрын
بارك الله فيك ان شاء الله 🤍
@abrabr6720
@abrabr6720 5 ай бұрын
و إياكم بالمثل يارب
@Gun1ld
@Gun1ld 5 ай бұрын
I use PAT 3 and increase the average by +1 combined with sat pulses to remove any kind of respiratory induced motion artifacts.
@mirelamihaila1884
@mirelamihaila1884 5 ай бұрын
Thank you so much, very helpfull.
@abrabr6720
@abrabr6720 5 ай бұрын
Thank you.
@amersfoorter82
@amersfoorter82 5 ай бұрын
I always do this👍
@sirajahmedsaifi8694
@sirajahmedsaifi8694 5 ай бұрын
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.
@fishyKRIMINAL
@fishyKRIMINAL 5 ай бұрын
I had the same problem and came up with this same remedy
@markdiller3217
@markdiller3217 4 ай бұрын
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
@Nguyen_MRI 4 ай бұрын
Hi thanks. Just Powerpoint yes. For recording in the scanner it's camtasia.
@vinothravi3736
@vinothravi3736 4 ай бұрын
Very informative. I appreciate your effort .please make video about cardiac MRI and Elastography
@Nguyen_MRI
@Nguyen_MRI 4 ай бұрын
@@vinothravi3736 kzbin.info/www/bejne/r5PQi4V-f69kbaMsi=RW0unF1XJ4nc5kMs
@hunnymun1
@hunnymun1 5 ай бұрын
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
@Nguyen_MRI 5 ай бұрын
@@hunnymun1 good idea. In the video i also showed the result H-F
@shastriramroop4815
@shastriramroop4815 4 ай бұрын
Would the change in position work for a flex coil also?
@Nguyen_MRI
@Nguyen_MRI 4 ай бұрын
@@shastriramroop4815 sure.
@markward2767
@markward2767 4 ай бұрын
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
@Nguyen_MRI 4 ай бұрын
Thanks for sharing your experience ☺️
@michelvandijk2745
@michelvandijk2745 5 ай бұрын
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
@Nguyen_MRI 5 ай бұрын
True said 👍
@anniesshenanigans3815
@anniesshenanigans3815 Ай бұрын
I have been doing this for years.. try to show my coworkers and some just ignore me.. and have all sorts of issues with shoulders.. PLUS it also helps to keep the images from Flipping on the Coronals.
@suhaimiss7322
@suhaimiss7322 5 ай бұрын
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
@Nguyen_MRI 5 ай бұрын
Sure. Sat can be used
@michalorenc6376
@michalorenc6376 5 ай бұрын
Hi. It's a pity you didn't show the complete positioning of the patient including the coil.
@Nguyen_MRI
@Nguyen_MRI 5 ай бұрын
@@michalorenc6376 yeah i didnt think of that. But more less routinely positioning but with tilting part as i showed.
@haminh1714
@haminh1714 5 ай бұрын
I think we should increase phase oversampling which will also help increase image quality
@Nguyen_MRI
@Nguyen_MRI 5 ай бұрын
True, but not these kind of artifacts.
@lidorganon7585
@lidorganon7585 5 ай бұрын
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
@Nguyen_MRI 5 ай бұрын
Truly believe it will work yes 👍
@mirelamihaila1884
@mirelamihaila1884 4 ай бұрын
Hi. So you elevated the opposite shoulder not the other shoulder with the coil on? 🤔
@Nguyen_MRI
@Nguyen_MRI 4 ай бұрын
@@mirelamihaila1884 hi. The opposite shoulder is tilted a bit as the video shows.
@mirelamihaila1884
@mirelamihaila1884 4 ай бұрын
Thank you so much. I'll definitely try it​@@Nguyen_MRI
@mirelamihaila1884
@mirelamihaila1884 Ай бұрын
Hi Bac. I did a shoulder today and i understood where the problem was, usually i angulated more than 45 degrees, but today only 35 degrees and the examinatiin was ok. Thank you so much for all the videos.
@indiantiger4550
@indiantiger4550 5 ай бұрын
Plz make a video on dti plz request
@Nguyen_MRI
@Nguyen_MRI 5 ай бұрын
kzbin.info/www/bejne/gpOakIqvnLyJsJIsi=MhN0MRrQGLRjqFaa
@aakib_parray1470
@aakib_parray1470 5 ай бұрын
Why shoulder joint is more susceptible to artifacts
@Nguyen_MRI
@Nguyen_MRI 5 ай бұрын
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
@DouglasBoyd-uh8cc 5 ай бұрын
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
@Nguyen_MRI 5 ай бұрын
Thanks 😊
@jimt2316
@jimt2316 5 ай бұрын
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
@Nguyen_MRI 5 ай бұрын
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
@Nguyen_MRI 5 ай бұрын
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
@iggyantioch 5 ай бұрын
This works. I had a colleague show me something similar. I am going to combine yours and his. Thanks for the video!
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