Brain MRI scan protocols, positioning and planning

Patient Preparation and Positioning for Scanning
📌 After safety checks, bring the patient into the scanner room and assist them in lying supine on the bed with their head in the head coil.
📢 Provide the patient with an emergency buzzer and ensure they know how to use it, while also supplying headphones for ear protection.
📐 Center the patient to the glabella and move them carefully into the scanner, ensuring they are calm and comfortable before exiting the room.

Control Room Setup and Protocol Selection
⚙️ Back in the control room, select the correct patient details or input them manually, critically verifying information like patient weight for accurate scan calculation.
📋 Register the patient as lying headfirst and supine, then select the correct protocol according to hospital and radiologist guidelines.
📐 Begin with an initial Scout or localize sequence in three planes and plan the axial sequence in all three planes, ensuring correct centering and coverage.

Sequence Planning and Centering Details
📐 Axial sequence planning: Ensure slices pass parallel to the line joining the inferior border of the genu and the splenium of the corpus callosum, covering the brain from vertex to below the foramen magnum.
📐 Coronal sequence planning: Central slice should run along a line from the superior sagittal sinus through the third ventricle and down the brainstem center; slices must be perpendicular to the line from the genu to the splenium of the corpus callosum.
📐 Sagittal sequence planning: Central slice should run parallel to the midline of the brain; ensure full side-to-side coverage.

Diffusion and Contrast Considerations
🛡️ Diffusion axial slices should be planned parallel to a line from the glabella to the foramen magnum to minimize artifacts near the paranasal sinuses/skull base border.
💉 If gadolinium injection is requested, it is essential to check the patient's kidney function and only proceed if safe, following national and hospital guidelines.
🔁 Post-contrast sequence planning can often copy planning from pre-contrast T1 sequences, but ensure correct contrast name and volume are entered into scan details.

Image Review and Sequence Characteristics
🔍 Review images as the scan progresses; in T2 images, fluids and fat appear bright, and most pathologies also appear bright.
⚫ In a FLAIR sequence, fluid appears dark while fat remains bright, making it useful for pathologies near ventricles/sulci where CSF is bright on normal T2.
⚫ On a T1 sequence, fluids appear dark, fat is bright, and most pathologies appear dark.
💡 In B1000 diffusion sequences, areas of restricted diffusion (e.g., stroke) appear bright, while on the ADC map, these areas appear dark.

Key Points & Insights
➡️ Ensure patient comfort and knowledge of emergency procedures (buzzer use) before starting the scan.
➡️ Accurate entry of patient weight is critical for the precise calculation of the scan dose/parameters.
➡️ For contrast administration, verify kidney function pre-scan and confirm the patient is well post-injection before leaving the room.

📸 Video summarized with SummaryTube.com on Jan 28, 2026, 11:22 UTC