How do I scan an MRI of the Wrist?


MSK may be the most dreaded cases to come through your department if you work in a hospital setting! It is simply not as common as Neuro, Spine and even Body MRI. Don't fear with this guide you will find the correct way to scan the toughest of MSK body parts even that pesky thumb scan.

WRIST

Axial T1 - Angle parallel with radial and ulnar styloids on a coronal image and perpendicular with carpal bones on a sagittal image. Slices should include all carpal bones and the entire DRUJ (distal radial ulnar joint).

Axial PD Fat Sat - Angle parallel with radial and ulnar styloids on a coronal image and perpendicular with carpal bones on a sagittal image. Slices should include all carpal bones and the entire DRUJ (distal radial ulnar joint).


Coronal T2 Fat Sat Option 1 - Angle parallel with the carpal retinaculum/ flexor retinaculum on an axial image. The carpal retinaculum is typically regarded as the superior method due to its alignment with carpal rows but can be difficult to see to the untrained eye. Angle parallel with the average of the carpal on a sagittal image. Option 2- Angle parallel with the radial and ulnar styloids on an axial image. Angle parallel with the average of the carpal on a sagittal image. Slices should cover from skin to skin anterior to posterior. The FOV shou Include all carpal bones and carpometacarpal joints superiorly and the entire DRUJ inferiorly.

Imaging Tip: Flow comp in the read direction is extremely helpful in the fluid sensitive coronal sequence. Radial and ulnar vessels can cause some serious flow in your image.

Coronal T1 - Angle parallel with the carpal retinaculum/ flexor retinaculum on an axial image. Angle parallel with the average of the carpal on a sagittal image. Slices should cover from skin to skin anterior to posterior. The FOV shou Include all carpal bones and carpometacarpal joints superiorly and the entire DRUJ inferiorly.


Sagittal PD Fat Sat - Angle perpendicular to a line drawn between the radial and ulnar styloids on an axial image and parallel to the radiocarpal joint on a coronal image. Slices should include from the first CMC joint to a couple slices beyong the ulnar styloid. The FOV should Include all carpal bones and carpometacarpal joints superiorly and the entire DRUJ inferiorly.

Sagittal T2 - Angle perpendicular to a line drawn between the radial and ulnar styloids on an axial image and parallel to the radiocarpal joint on a coronal image. Slices should include from the first CMC joint to a couple slices beyong the ulnar styloid. The FOV should Include all carpal bones and carpometacarpal joints superiorly and the entire DRUJ inferiorly.


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