non Contrast Enhanced MRA "How I Do It"

Welcome back to another episode of my KZbin channel. For those who don’t know me, I’m Bac Nguyen, MRI Radiographer. In my channel I covers everything from basic MRI to advance, tips tricks etc.. For those who already following me, I just want to say many thanks.
In this video I want to show you “how I do it” with the 3D TrueFisp with ECG and respiratory triggering (Balanced Steady-State Free Precession). We will be directly at the scanner where I take you through step by step from the start till the end. I will try to break down many important steps with explanation. Unfortunately, I will not talk about how to optimize this sequence itself in this video, just how to plan it.
#S_MAGNETIC_VLOG #MRI #SIEMENSHEALTHINEERS #3D_TRUEFISP
References
Note image: bit.ly/3897FmO

[@dtdm124]

Great video. Thanks Bac!

[@jobinveloor5792]

This type of video is needed more, thankyou

[@alpha_uncle_6]

Well Done Bac, that’s the kind of video that we’ve been waiting for a long time...👍

[@tuthy9587]

Dude, thx for this. Finally a yt channel for MRI.

[@atleyishere]

Great video. I’m glad you remembered at the end to show the default protocol you started with. Thank you, and keep the videos coming!!!!

[@dzmitryhaviazheu5199]

Beautiful scan and technique! Great job!

[@3Captainjack]

Great video Bac am just a learner trying to understand MRI in depth, your video helps

[@dervendic]

I didn't realize you have a KZbin channel. I'm a follower now.

[@user-hx5zv7xe9h]

thanks for spreading knowledge as simply as you can ! i think it's great !

[@hunnymun1]

thank you for your videos! Bac! I'm a new mr tech, your videos really helping. 👍👍

[@Nguyen_MRI]

Glad to hear ☺️

[@mdmohibullah2361]

Exceptional Video thanks

[@arkadiuszlittlecurtain3078]

Hahah.. the part about questions.. am still saying the same thing. And then this 'there was this one time' story about a problem with starting the exam, or even selecting protocol and going further on one of the older GE scanners. this was during application training, 7:30 a.m. and had to make a phone call to one of the manufacturers expert application specialists... the solition was just one, the most obvious click from keyboard :)) he also tells this anegdote about not too clever questions. so... if someone hear it, the guy making this call was me ;) BigUp! its a pity we couldnt meet in Vienna, later or next time. Great stuff U do. Thanks. Keep going.

[@Nguyen_MRI]

Thanks. Hopefully we catch up at another meeting. 😊

[@fountainvalley6763]

Thank you so much

[@singerskimander9049]

GREAT VIDEO ,I AND OTHER ALSO WORK ON UR GUIDENCE: GREAT WORK SIR

[@Nguyen_MRI]

I’m glad to hear this can be helpful 😊

[@ckyluck2881]

Thanks Sir🎉🎉🎉🎉🎉

[@vominh6756]

Great! anh Bac

[@CC-hv1hy]

Bac, do you know how to utilize contrast enhanced MRA using a timing bolus technique? I’ve never been taught how to use it. If you do, can you make a video of that? Thank you for all you do. I’ve learned a lot watching your videos!!

[@muhammadharoon701]

Very good channel. Can you make a video on how to save protocol in user library and how to take back up and restore. Thanks

[@xxurusaixx]

Did subscribed to your channel recently. It is very informative and useful. I'm so glad that you're using Siemens system which really helped me a lot towards my career on MRI. Thank you very much for willingly sharing your knowledge through creating videos. Question, does this steps/techniques you used same goes when doing Renal MRA? I got a little trouble optimizing on where to put the sat band to reduce unwanted signals just to focus only the arterial vessels. Maybe you can also do a tutorial video for this. Thanks in advance!

[@Nguyen_MRI]

Thanks for following and kindly words. Well, the setup is not the same. Please check this link for how to perform this. mriquestions.com/uploads/3/4/5/7/34572113/non_contrast-enhanced_mr_angiography-00012410.pdf

[@ShijoD]

You can follow same protocol for Renal MRA without contrast)? Thanks

[@chrislatsch8237]

Excellent video. I currently have a 1.5 aera and will be getting a 1.5 Sola next month. We don't have the cardiac package and won't be anytime soon. Is there another way we could get a similar result without that sequence? Keep up the great videos!

[@Nguyen_MRI]

It can be difficult for sure. I tried other approaches but without any good results. Congrats with the new sola. Great scanner and wish you and the team good luck with that one 👍

[@Neph45778]

wow thanks

[@dzmitryhaviazheu5199]

Quiescent time = End Diastolic Stand still (the time when the hard is “motionless” for a brief period and the best to reduce motion artifact, image coronary arteries, etc.

[@Nguyen_MRI]

Thanks for valuable input ☺️

[@Neph45778]

I'm trying to make a similar sequence using the angio native truefisp nav ecg but I can't lower the TR, can you show me all the parameters?

[@vc7417]

OMG you save my life. We havea casr coming up and I was wondering how to do it. Is itpossible for you to do non contrast mra abdominal as well. Thanks.

[@Nguyen_MRI]

You can use a space stir which enhance all vessels unfortunately.

[@badrlinux6786]

great video man, please im new radiographer in morocco, i use siemens MR olso, i will be very happy if u explaine more protocole like strock and TSA angio in siemens console with comment of all option card for siemens interface MR software, other ways if u can explaine for us how to use every option on siemens like ipat emagung option, fluroscopie for angio, ecg and pace .... thank you very much Mr Bac Nguyen and good luck

[@ibbu1086]

Wow , you working in Morocco as a Radiographer. I also wanted to work as a Radiographer in Morocco. By the way my name is Ibrahim working as an MRI Radiographer in England. Why don’t you come to England. Please be in touch . Good luck bro.

[@badrlinux6786]

@@ibbu1086 hello Ibrahim, thank you bro for the idea 😉, im feeling good here in morrocco and i have family you see 😂. Please if you visit morocco come visit me in Marrakech, your welcome bro "tanjia"🎊🎉

[@ibbu1086]

@@badrlinux6786 I have great memories with Marrakesh. I will visit again, Inshallah . My WhatsUp number ‪[phone]‬.

[@dongkil8018]

Thank you for this helpful video. I have a question. I tried this seuqence, but the scan(almost 10~15s scan) was stopped suddenly. No image datas, but only Breathe pattern and position histogram i got. What am i doing wrong ??

[@Nguyen_MRI]

Yes you need to go into physio card. And part 2. Turn of scout mode. Scout mode only last around that time to provide you the breathing pattern values.

[@Neph45778]

I don't have the advanced cardiac package on the Siemens MR :( but I think I will be able to apply some of this on the GE

[@Nguyen_MRI]

keep me updated :)

[@Neph45778]

@@Nguyen_MRI how to lower the TR? I'm using the thorax version of this sequence, it has a good resolution but the blood pool is dark

[@debbiewatson8429]

HeyBac. Do you have any mra carotid video. I’m new to Siemens. Thank you

[@Nguyen_MRI]

No not yet

[@dzmitryhaviazheu5199]

Bac, do you use Beta Blockers in your institution to slow down the heart rate and hence shorten than scan time?

[@Nguyen_MRI]

No we don't unfortunately. Would be definitely helpful in these cases. Do you use there at your site?

[@snjang77]

In 3T , it will be more challenging to do this sequence. May I ask you about non contrast lower neck MRA ,including arch outflow and bilateral subclavian arteries? What sequence will you use?

[@Nguyen_MRI]

Good question. This sequence is very difficult on 3T due to its physics itself. However, it’s possible. But we don’t choose 3T if having cases as you ask. But if have to and only 3T available, you can try the bright blood 3D space stir.

[@osirisgiovannisalazar1670]

Thanks for another great video! Can you give me any tips and/or direct me to a source with info to improve ECG signal? We already use abrasive gel followed by conductive gel but sometimes once the patient is inside the bore the ECG signal suffers from a lot of interference, if we take the patient out of the bore the signal returns to being simply beautiful without having to do anything else. We're using Siemens Skyra. Thank you 👍

[@Nguyen_MRI]

3T can be challenging. Have you tried different types of ecg pads? We use NUPREP to rubber the patients first. I notice without that it’s very challenging

[@osirisgiovannisalazar1670]

@@Nguyen_MRI right, nuprep is what we use, it does make a huge difference. We’ll see about trying different ECG pads, thank you 👍🏻

[@geetpreet7314]

Make a vedio of MRA upper limb with TOF.

[@ngcindy9578]

Hi Boc, thank you so much for the video. May I ask, when you point to trigger delay, there are two lines …data window duration, and data window start… you said the data window duration controlled by segments , but u didn’t show the final duration after u adjust the segments, I just want to confirm , after u adjust segments, in your sample to around 60 something, the duration will change to 150 as you calculated?

[@Nguyen_MRI]

Correct. This various from heart rate to heart rate. What I have in that specific video will various anyways so you must understand the start time and the duration you can have to tailor in this for that specific case of yours.

[@ngcindy9578]

@@Nguyen_MRI ,thx a lot Bac

[@anielvictor794]

perfect video, I really liked your work, I'm MRI Radiographer in Brazil, and I wanted to know what the name of this sequence is on the GE platform

[@Nguyen_MRI]

Inhance flow I believe can be used in that region as well. Haven’t tried it myself. But this paper seems interesting and worthy to check out : www.sciencedirect.com/science/article/pii/S0002870313005899

[@Nguyen_MRI]

Actually you can do 3D fiesta sync with navigator and cardiac. Put on fatsat

[@anielvictor794]

@@Nguyen_MRI Thank you

[@utkarshyadav6541]

Sir kindly provide information about mri neurography for limb

[@nazishsaeed7038]

Great video👍 but i have a query. u say at lower heart rate the scan time is short and vice versa but my practical observation is contrary to this. At higher heart rate the scan time is short (less breath hold time). Kindly comment on this. Sometimes when i perform nav sequence it just show me a histogram pic not the required 3D image. unable to understand why is it so.

[@Nguyen_MRI]

Thanks for comment. A bit difficult to understand this. The thing is that lower heart rate the R R interval is longer. Which means you able to sample longer within that R R. Inside a RR the sequence need time to prep also. So by having a fast heart rate the RR is so close which in terms means you don’t have time to sample that much - longer scantime. This of course only if you are tailoring your sampling whenever the heart is still like I show in this video.

[@nazishsaeed7038]

Thanks.. Kindly comment on second part of my reply.

[@Nguyen_MRI]

Regarding the second part I have not encounter this issue. I know you can turn off the request of the breathing histogram, thereby no histogram available at the end of scan. But not having the raw data available when sequence is finish I never seen before. Only if the scans fail or so.

[@twwoody813]

Hi Bac, not sure what I am doing wrong with non contrast aorta scan. But I cannot seem to get an acceptable acceptance number. In Your example the is accept number around 39. When I am doing this my accept is only in the 20 mark ? Is it patient breathing or something I am missing out ? Thanks

[@Nguyen_MRI]

acceptance can various due to patient breathing pattern. are you carefully putting the navigator at the right position on free breathing localiser two planes?

[@twwoody813]

@@Nguyen_MRI Hi Bac, I am quite sure sure the navigator is in the correct position. As I have used the same principle as yourself. So it must be patients breathing. Thanks again

[@cisnikko]

In 8.40 you clicked on Capture Cycle, but on 11.00~ you applied the sequence without clicking the capture cycle. Why is that? TIA.

[@Nguyen_MRI]

yes correct, it can be a little bit confusing. at 8.40 i capture cycle once so it will easier for me to tailor the ECG as shown. then i start the sequence just to see how the patient is breathing before i stop the sequence, pull it down and adjust the pace (search position red). if i at 11:00 hit the capture cycle again, then my tailored ECG will be ruined. that i dont want to happen.

[@jverd4635]

hi bac i got lost a bit where did you put the 150? thnx

[@Nguyen_MRI]

Repeat the video at approx 8:41. Where I explain in depth what to do

[@hopsie9983]

Hi Bac, were you suppose to change the segments box from 65 to 150 as mentioned?

[@Nguyen_MRI]

hi, in this video example you need to find the start and and. so i found start 650 and end 800. if you take 800 - 650 = 150 durations. you can change the start 650 at the exam card signa1 - trigger delay. next step is to tune in the duration which is in the same exam card, but down below, segments. tune in the segments to approx 150.

[@hopsie9983]

@@Nguyen_MRI Hi Bac, when you were changing the segments, where were you checking that it showed 150, was it on the ECG cycle graph?

[@Nguyen_MRI]

@@hopsie9983 hover the mouse over trigger delay. You Get the info there

[@hopsie9983]

@@Nguyen_MRI ahh yes got it now, looking forward to trying this out, thanks. Future tutorials...t1 mapping post processing? For contrast enhanced aorta, do you use twist seq or classic 2d seq pre/post?

[@Nguyen_MRI]

@@hopsie9983 for aorta depends. If the radiologist wish to have high temporal resolution the twist. If not or more standard it’s 3D flash approach yes.

[@shaimaasalah4053]

Could u plz tell me protocol for aortography 3T Mri philips

[@Nguyen_MRI]

I dont have it for Philips. But please check this paper : onlinelibrary.wiley.com/doi/full/10.1002/jmri.21256

[@OmarM8055]

Do you know were I can find same study but for GE 1.5 T enhance imaging ??

[@Nguyen_MRI]

I'm sorry I'm not familiar with GE.

[@iggyantioch]

I'm building an GE enhance mra soon. I'll keep you posted

[@OmarM8055]

@@iggyantioch Thanks man !!!

[@Nguyen_MRI]

@@iggyantiochawesome. 👍

[@luminitagheorghe6163]

Hi when you do Mri you can put RF more or less? I do a mri and i feel like burnings

[@Nguyen_MRI]

Yes you can.

[@luminitagheorghe6163]

@@Nguyen_MRI it is possible that tehnician put me more RF than necessary? You calculate the weight when you use RF?

[@luminitagheorghe6163]

For 47 killo and 1,64 how much RF you can use for no adverse effects and burnnings?

[@luminitagheorghe6163]

Can you do a video woth all the coils that are used for mri? For all abdomen mri what type a mri is used?

[@Nguyen_MRI]

@@luminitagheorghe6163 one important reason you have to put in weight and height so the scanner can calculate. Difference between adult and child etc.

[@Keyboardwarrior6977]

Is it always better to use contrast? I have an MRI in literally 2 days and im having to decide contrast or no contrast without a cardiologist due to the fact I cant afford both the scan with report and a consultation?

[@Nguyen_MRI]

I see. Depends on clinical question if contrast is needed or not. You should talk to your referring physician regarding this.

[@Keyboardwarrior6977]

@@Nguyen_MRI See i've had to self refer, would you recommend contrast? I have no allergies or kidney problems, and I just want to know why I've been getting pain in my heart?

[@Nguyen_MRI]

I can’t give advice regarding this. Because I don’t have the permission or knowledge to do so. Whenever patients comes to MRI I do my best from there to answer the clinical question.

[@Nguyen_MRI]

Maybe it’s better to do non contrast first. Then come back if the radiologist can’t find the answer. That’s my best advice from the information I have from you.

[@laxmannetha2113]

ASL 3D Sequence explain acute infact

[@twwoody813]

Hi Bac, when doing a non contrast renals and aorta at the same time on a patient. Would you just use the bellows or ecg ? thanks in advance

[@Nguyen_MRI]

I personally would go for ecg

[@twwoody813]

@@Nguyen_MRI Thank you, very much appreciated.

[@anjuman-e-masoomeen9256]

One vedio shere mri angio neck with brain

[@yassienabead]

Hi renal angio MRI non contrast which sequnce the best for do it... Machine EEZENZA SIEMENS

[@Nguyen_MRI]

Native truefisp.

[@yassienabead]

@@Nguyen_MRI is it with triger or not?

[@Nguyen_MRI]

Triggered. cdn0.scrvt.com/39b415fb07de4d9656c7b516d8e2d907/1800000001175538/4bcb3eea9c9e/native_truefisp_respiratory_trig_1800000001175538.pdf

[@yassienabead]

@@Nguyen_MRI thanks alot. Hhhhh. But in my machine dosent active...

[@Nguyen_MRI]

It means you don’t have it. It’s a package which needs to be bought.

[@NiteVibeScribe]

What was the overall time of acquisition for this particular example?

[@Nguyen_MRI]

Depends on the heart rate, coverage, resolution and breathing pattern. Can take everything from 2-5 minutes.

[@NiteVibeScribe]

Thank you. I have another question. When you adjusted the segments where did you look on the control panel to ensure the 150 optimal duration time had been set?

[@Nguyen_MRI]

You go into the physio - signal1 tab. Then you hover over trigger delay. You get start and duration time there. Duration is controlled by segments.

[@Nguyen_MRI]

Trigger delay parameter shows : data window acquisition in terms duration. While data window start in terms start. Thanks.

[@yongmsong]

@@Nguyen_MRI Hey Bac, I think in the video, the duration was still over 200 ms unless I missed it. After you brought the segment down, did it come down to 150 ms?

[@vinodkhanna2170]

GOOD MORNING IN SIEMENS MACHINE WHAT IS ISO HOW WE USE IN MRI NECK ANGIO

[@Nguyen_MRI]

Good morning. Check this: kzbin.info/www/bejne/mJ_ZcmaInadge9ksi=yjmcgIPSP8EqOx-V

[@filippobovero8080]

Hi. Was this done on Siemens Aera 1,5t or Siemens Skyra 3t?

[@Nguyen_MRI]

Hi 1.5t aera. Can be done on 3T as well but more challenging.

[@filippobovero8080]

@@Nguyen_MRI thank you bac! Keep doing like this! You rock!

[@Nguyen_MRI]

@@filippobovero8080 thanks for kindly words.

[@filippobovero8080]

@@Nguyen_MRI Hi bac, just another question for you...where can i find the CINE free breathing sequence to check the quiescent time in the Siemens tree?

[@Nguyen_MRI]

@@filippobovero8080 just use your current cine sequence. 1. Add on avg to 2-3. 2. Run it with retrospective ecg triggering. 3. Calculated phases to 60. 👍

[@petrostsegaye7065]

Hi Mr I am from Ethiopia 🇪🇹 working in mri in our department we have new siemens 1.5 T can you send me MRI SOP if you can please thank you

[@user-kg4ny3gb3r]

anh là người việt nam ạ

[@Nguyen_MRI]

👍

[@user-kg4ny3gb3r]

@@Nguyen_MRI anh đang công tác ở đâu vậy ạ ?

[@Nguyen_MRI]

@@user-kg4ny3gb3r na-uy