Guidelines for MRI in Paediatric Brain Tumours

This protocol is amended from:- Clinical Radiology, September 1999,54(9);558-562

1. Supratentorial Tumours
Presentation
Immediate Post-Surgery
Late Follow-up
2. Infratentorial Tumours
Presentation
Immediate Post-Surgery
Late Follow-up

Cranial

Axial dual echo SE (spin echo) or FSE (fast spin echo)
Coronal T1 SE
Post contrast (i.v. gadolinium DTPA) T1 SE in at least two orthogonal planes.

Spinal

Post contrast whole spine sagittal T1 SE Axial T1 SE if equivocal
Guideline parameters:

Cranial:-	Slice thickness <5 mm FOV (field of view) 180-230 em Matrix <256x256 (effective) T1 SE TR:<800 msec. TE: <25 msec T2 SE TR:2,000-2,600 msec, TE:20/90 msec T2 FSE TR:3,000-4,000 msec, TE:20/90 msec
Spinal:-	T1 SE TR: <600 msec TE: <25 msec Slice thickness <4 mm

Contrast medium: i.v. line to be placed prior to attending MR department where possible. I.V. Gadolinium DTPA 0.1 mmol/kg

Timing:	Within 72 hr
Sequences:
Cranial:-	Coronal Tl SE Axial dual echo SE/FSE Post-contrast T1 SE in at least two orthogonal planes
Spinal:-	Not recommended, see text

Parameters and contrast medium:- as above

Timing:-	Protocol driven - dependent on tumour type
Sequences:-
Cranial:-	Coronal TI SE Axial dual echo SE/FSE Post-contrast TI SE in at least two orthogonal planes
Spine:-	Post-contrast whole spine sagittal TI SE (If histology indicates tumour type with potential to seed through the CSF).

Parameters, contrast medium:- As before

Sequences:-
Cranial:-	Whole brain axial coronal TI SE Whole brain T2 SE/FSE axial Sagittal T2 through brainstem for brain stem glioma Post-contrast T 1 SE in at least two orthogonal planes
Spinal:-	Post-contrast whole spine sagittal T1 SE
Parameters:-	As for supratentorial lesions Slice thickness <5 mm

Contrast medium:- i.v. line to be placed prior to attending MR department, when possible. I.V. Gadolinium DTPA 0.1 mmol/Kg.

Timing:-	Within 72 hr
Sequences:-
Cranial:-	Whole brain coronal T1 SE Axial T2 SE/FSE Post contrast T 1 SE in two orthogonal planes
Spinal:-	Not recommended, see text

Parameters, contrast medium:- As before

Parameters: As before

Timing:-	Protocol driven (dependent on tumour type)
Sequence:-
Cranial:-	Whole brain coronal T1 SE Whole brain axial T2 SE/FSE Post contrast T1 SE in two orthogonal planes
Spinal:-	Post contrast sagittal T1 SE

Contrast medium:- As before