MRI Protocols & Scan Parameters (2025–2026)

Representative values, not prescriptions. Parameters vary by vendor, field strength (1.5 T vs 3 T), coil, and local preference, and are increasingly compressed by parallel imaging, compressed sensing, and deep-learning reconstruction. Vendor names map the closest common equivalent and differ by software version. ACR figures are ceilings/minimums, not optimal technique. Defer to your institutional protocol and the linked primary sources. Educational reference, not clinical or safety advice.

Guidelines verified July 2026Representative values — defer to your institutional protocol.Tip: press Ctrl / ⌘ + P for a clean printable PDF.Spotted an error? Tell us

Overview

Cross-cutting 2025–2026 developments that shape every protocol below.

High-Yield Pearls — cross-cutting

MR safety (ACR 2024): a “full stop” final safety check precedes every scan, routine or emergency; new MR risk-assessment appendix for implants; strict Zone III/IV discipline.
Contrast (ACR 2025): macrocyclic / Group II agents are the lowest-risk GBCAs; weight-based dosing; group-based renal screening rather than a blanket eGFR cut-off.
Contrast-sparing is the trend: biparametric prostate, abbreviated liver/breast, and non-contrast MRA increasingly replace routine gadolinium.
Acceleration & AI: deep-learning reconstruction with parallel imaging cuts scan time substantially — validate image quality locally before clinical adoption.

Cross-cutting updates

MR safety (ACR)

Full stop / final check before scanning, routine and emergency.²
Pocketless attire; tether external equipment in Zones III/IV.¹
New MR Risk-Assessment Appendix for implants with unclear conditions; remote-scanning staffing.^2,3

Contrast media (ACR 2025)

Group II macrocyclic agents — routine eGFR screening optional; eGFR<30/AKI highest-risk; cumulative “GBCA burden”.⁴
Breastfeeding need not be interrupted; screening now risk-factor-targeted (CIN → CA-AKI).⁴

Acceleration & AI reconstruction

Deep-learning recon (AIR Recon DL, Deep Resolve, SmartSpeed, AiCE, ACS) layered on parallel imaging + compressed sensing; up to ~85% gradient-time reduction.⁵
Watch for sequence-specific artifacts, oversmoothing/"hallucination", poor low-field generalisation — validate locally.⁵

Gadolinium trend

Gadopiclenol: high-relaxivity macrocyclic at half the standard dose; FDA use expanded to neonates/infants (2026).⁶
Every GBCA in routine US use is now Group II.⁴

Neuro & spine

Brain and spine. Where a pathology needs a distinct protocol it is listed in full — set your vendor above to translate sequence names.

High-Yield Pearls — neuro & spine

Routine brain = T1, T2, FLAIR, DWI, SWI (± post-Gd 3D T1). DWI is the non-negotiable sequence — stroke, abscess, CJD, cellularity.
Stroke: DWI + FLAIR + SWI/GRE + MRA in minutes. A DWI-positive / FLAIR-negative mismatch implies onset <4.5 h → thrombolysis candidate in wake-up/unknown-onset stroke (WAKE-UP).
MS (2024 McDonald): 3D FLAIR is the primary detection sequence; central vein sign and paramagnetic rim lesions (optimally 3T SWI) add specificity; gadolinium is increasingly optional.
Epilepsy (HARNESS-MRI): 1 mm-isotropic 3D T1 + 3D FLAIR plus a high-resolution coronal T2 ⊥ the hippocampal long axis.
Brain tumour (BTIP): parameter-matched pre/post 3D T1 is what enables reproducible RANO response assessment.
Spine: sagittal T1 + T2 ± STIR; add fat-sat post-Gd for infection/tumour/post-op; screen the whole spine for cord compression or drop metastases.

Brain

Routine brain0/6

First-line brain screen. Add post-contrast T1 for tumour, infection, or active MS.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
or 3D T1	Ax	500–700	8–15	–	5 / 1	220–240	320×256	Anatomy
	Ax	3500–5000	90–110	–	5 / 1	220	384–512	–
	Ax	8000–9000	90–120	2400–2500	5 / 1	220	256	TI↑ at 3T
	Ax	3000–5000	min	–	4–5	230	128–160	b0/1000; ADC
	Ax	27	20–40	–	2–3	220	256–320	minIP; blood/mineral
post-Gd if indicated	Sag 3D	1900–2300	2–4	~900	1 iso	240	256	Volumetry

ACR-ASNR-SPR practice pattern.⁷

Acute stroke0/5

Speed-first; DWI+FLAIR+SWI+MRA in minutes. Add neck CE-MRA/TOF for carotid/vertebral. Extended wake-up windows (>4.5–9 h) are evolving, not yet uniform guideline.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Ax	3000–4000	min	–	4–5	230	128–160	b0/1000; ADC — infarct core
	Ax	8000–9000	100–120	2400	5	230	256	DWI+/FLAIR− mismatch → likely <4.5 h
or GRE	Ax	27	20–40	–	3	230	256	Haemorrhage, susceptibility vessel sign
intracranial	Ax 3D	20–25	3–7	–	0.6–1	200	320	Circle of Willis; large-vessel occlusion
optional	Ax	1500	30–45	–	5	230	128	Penumbra (PWI)

AHA/ASA; ESO; DWI–FLAIR mismatch; extended windows.^8,9,10,11

Multiple sclerosis0/5

2024 McDonald + 2024 MAGNIMS–CMSC–NAIMS. ≤3 mm/no gap; consistent repositioning for follow-up.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag 3D	5000–8000	~390 eff	1800–2200	1 iso	250	256	Primary lesion detection
pre ± post-Gd	Sag 3D	2000	2–4	~900	1 iso	250	256	Single dose, ~10 min delay
	Ax	4000	90	–	3	230	320	Posterior fossa
	Ax	3000	min	–	4	230	160	Exclude mimics
	Ax	27	20–40	–	2–3	220	320	Central vein sign / rim lesions (optimally 3T)

McDonald 2024; MAGNIMS–CMSC–NAIMS.^12,13,14

EpilepsyHARNESS0/4

ILAE HARNESS-MRI. Correct head tilt/rotation on the localiser before the coronal T2.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag 3D	2000	2–4	~900	1 iso	256	256	Morphology / cortex
	Sag 3D	5000–8000	~390 eff	1800–2200	1 iso	250	256	FCD / gliosis
high-res	Cor obl	5000–9000	90–110	–	2 / 0	180–200	512	⟂ hippocampal long axis; ~0.4 mm
if lesion	Ax	27	20–40	–	2–3	220	320	Add post-Gd T1 if tumour/vascular

ILAE HARNESS-MRI.¹⁵

Brain tumourBTIP0/6

Standardised BTIP; identical pre/post parameters enable RANO response assessment.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
pre	Sag 3D	2100	min	400–450	1 iso	256	256	Parameter-matched
	Ax	4000	100	–	≤4 / 0	240	384	–
	Ax	8000	120	2400	≤4 / 0	240	256	Pre-contrast
	Ax	4000	min	–	4	240	160	b0/1000; ADC (cellularity)
post-Gd	Sag 3D	2100	min	400–450	1 iso	256	256	Identical to pre
advanced, optional	Ax	1500	30–45	–	5	240	128	Perfusion (rCBV) ± spectroscopy

Consensus BTIP.^16,17

Dementia / neurodegeneration0/5

Reformat coronal-oblique T1 through hippocampi for MTA (Scheltens); optional volumetry.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
coronal-oblique reformat	Sag 3D	2000	2–4	~900	1 iso	240	256	MTA ⟂ hippocampus
	Ax	8000	120	2400	5	230	256	Vascular burden
	Ax	4000	100	–	5	230	320	–
	Ax	27	20–40	–	2–3	220	320	Microbleeds / CAA
	Ax	3000	min	–	4	230	160	Exclude CJD/acute

Radiology Assistant; ACR appropriateness.¹⁸

Pituitary / sella0/4

Thin-section sella; dynamic post-contrast for microadenoma. Representative standard technique.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
pre	Sag & Cor	400–600	10–15	–	2–3 / 0	160–180	320–512	Small FOV, thin
	Cor	3000	90	–	2–3	160–180	384	Chiasm, cysts
dynamic post-Gd	Cor	min	min	–	2–3	160–180	256	~6 phases — microadenoma
post-Gd	Sag & Cor	400–600	10–15	–	2–3	160–180	320	Delayed

IAM / CPA (hearing loss)0/4

Thin 3D heavy-T2 (CISS/FIESTA-C/DRIVE) + post-Gd T1 for CN VII/VIII. Representative standard technique.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Ax 3D	6–10	3–5	–	0.5–0.6 iso	150–160	320	Membranous labyrinth, CN VII/VIII
pre	Ax	500	12	–	3	180	320	IAM fat
post-Gd fat-sat	Ax & Cor	500	12	–	3	180	320	Vestibular schwannoma
	Ax	4000	90	–	3–4	200	320	Posterior fossa

Pediatric

Feed-and-wrap for infants; fast HASTE/single-shot "quick-brain" for shunted hydrocephalus (no gadolinium, no sedation).^20,21
<24 months myelination incomplete — FLAIR insensitive to FCD; retain early scans for comparison.¹⁵
Macrocyclic Gd, single dose, omit where not needed.²²

Spine

Cervical (routine)0/4

Add fat-sat post-Gd T1 for infection/tumour/post-op.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	500–700	10–15	–	3 / 0.3	240–280	384	Marrow, alignment
	Sag	3000–4000	100–120	–	3 / 0.3	240–280	384	Cord, discs
	Sag	3000–4000	40	150–170	3	240–280	320	Oedema / trauma
or Ax T2 FSE	Ax	600–800	15–20	–	3–4 / 1	160–180	256–320	Foramina, cord

Representative routine protocol.¹⁹

Thoracic (routine)0/4

Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
Sag	500–700	10–15	–	3–4 / 0.5	320–400	384	Wide coverage — count levels
Sag	3000–4000	100–120	–	3–4	320–400	384	Cord
Sag	3500	40	150–170	3–4	320–400	320	Oedema
Ax	3500	100	–	4	180–200	256	Through ROI

Representative routine protocol.¹⁹

Lumbar (routine)0/5

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	500–700	10–15	–	3–4 / 1	280–320	384	Marrow, alignment
	Sag	3000–4000	100–120	–	3–4 / 1	280–320	384	Discs, canal
optional	Sag	3500	40	150–170	3–4	280–320	320	Oedema / infection
	Ax	3500–4500	100	–	3–4 / 1	180–200	320	Angled through discs
optional	Ax	600	12	–	3–4	180–200	320	Foraminal fat

Representative routine protocol.¹⁹

MS cord0/4

MAGNIMS cord protocol; slice ≤3 mm.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	3500	100–120	–	3	260–280	384	Cord lesions
or STIR	Sag	3000	30	–	3	260–280	384	≥2 of 3 sagittal contrasts
	Ax	3500	100	–	3	160–180	256	Full cord coverage — confirmation
post-Gd if active	Sag & Ax	600	12	–	3	260	320	Active lesions

MAGNIMS–CMSC–NAIMS.¹⁴

Infection / discitis0/4

Fat-sat post-Gd essential for epidural/paraspinal collection.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	500–700	12	–	3–4	280–320	384	Marrow, endplates
or T2 fat-sat	Sag	3500	40	150–170	3–4	280–320	320	Discitis/osteomyelitis
	Ax	3500	100	–	4	180–200	256	Canal, paraspinal
post-Gd fat-sat	Sag & Ax	600	12	–	3–4	280	320	Abscess / epidural phlegmon

Representative protocol.¹⁹

Cord compression / whole-spine0/4

Acute cord compression or cauda equina — large-FOV whole-spine screen.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	3500	100	–	3–4	400+ (2 stations)	384	Whole spine — compression / drop mets
	Sag	3500	40	150–170	3–4	400+	320	Marrow lesions
	Ax	3500	100	–	4	180–200	256	Targeted level
± post-Gd	Sag	600	12	–	3–4	400+	320	Leptomeningeal / mets

Musculoskeletal

Each joint lists its routine protocol plus pathology-specific/arthrography protocols in full. ACR figures are accreditation ceilings, not optimal technique.

High-Yield Pearls — musculoskeletal

Fat-sat fluid-sensitive (PD/T2 or STIR) on ≥1 plane finds marrow & soft-tissue oedema; T1 maps marrow and anatomy. ACR figures are accreditation ceilings, not optimal technique.
MR arthrography: dilute gadolinium to ~2 mmol/L (~1:200) intra-articular; the ABER view is key for the anteroinferior labrum / HAGL in shoulder instability.
Positioning drives the diagnosis: oblique-coronal ∥ supraspinatus (cuff), oblique-axial along the femoral neck (cam/alpha angle), radial reformats for the acetabular labrum, short-axis ⊥ metatarsals for Morton neuroma.
Metal (MARS): high receiver bandwidth, short TE, FSE not GRE, and STIR not spectral fat-sat; add SEMAC / MAVRIC-SL 3D multispectral for severe hardware artifact.
Whole-body (MY-RADS): axial DWI (b 50 & ~900) + Dixon T1; overall study quality is usually limited by DWI quality.

Knee

Routine (internal derangement)0/5

Fat-sat on ≥1 plane. ACR max 4 mm / 0.6 mm².

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	2500–3500	30–40	–	3–3.5 / 0.3	140–160	320–384	Menisci; ~0.4 mm
fat-sat	Sag	3000–4000	40–60	–	3–3.5	140–160	320	Cartilage, cruciates
fat-sat	Cor	3000	40	–	3	140–160	320	Collaterals, menisci
fat-sat	Ax	3000	60	–	3–4	140–160	288	Patellofemoral cartilage
or Dixon	Cor	500–700	12	–	3–4	140–160	320	Marrow (non-FS)

ESSR 2024; ACR MSK.^26,33

Cartilage / quantitative0/3

Quantitative T2/T1rho used in research and early OA; not yet routine clinically.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
fat-sat 3D	Sag 3D	1200	30	–	0.5–0.7 iso	150	320	Morphological cartilage; reformats
	Sag	1500	multi-echo	–	3	140	320	Collagen/water; T1rho adjunct
fat-sat	Sag/Cor	3000	40	–	3	140–160	320	Routine base

AJR 2024.³¹

MR arthrography (post-op)0/2

Post-op meniscal re-tear / cartilage. Macrocyclic Group II GBCA.

✓	Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	fat-sat	Sag/Cor/Ax	500–700	min	–	3	140–160	320	Dilute Gd ~2 mmol/L intra-articular
	fat-sat	one plane	3000	60	–	3	140–160	288	Loose bodies, oedema

Gd dilution vs field.²⁷

Shoulder

Routine (cuff / impingement)0/4

ACR max 4 mm / 0.8 mm².

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Ax	2500–3000	30	–	3–4 / 0.3	140–160	320	Labrum, biceps
fat-sat / STIR	Obl-Cor	3500	50–60	–	3–4	140–160	320	∥ supraspinatus — cuff
fat-sat	Obl-Sag	3000	40	–	3–4	140–160	288	Cuff muscles, Goutallier
	Obl-Cor	500–700	12	–	3–4	140–160	320	Marrow, fatty atrophy

ACR MSK.³³

MR arthrography (instability)0/5

Instability work-up; ABER view essential.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
fat-sat	Ax	500–700	min	–	3	140–160	320	Dilute Gd ~2 mmol/L; Bankart/SLAP
fat-sat	Obl-Cor	500–700	min	–	3	140–160	320	Superior labrum
fat-sat	Obl-Sag	500–700	min	–	3	140–160	320	–
fat-sat, ABER	ABER obl-ax	500–700	min	–	3	140–160	320	Anteroinferior labrum, PASTA, HAGL
fat-sat	one plane	3000	60	–	3	140–160	288	Cuff / oedema

Gd dilution; ABER.²⁷

Hip

Routine / AVN0/4

AVN, marrow, referred pain.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
or T2 fat-sat	Cor (pelvis)	3500	40	150–170	4–5	340–380	320	Both hips, marrow, AVN screen
	Cor (pelvis)	500–700	12	–	4–5	340–380	384	Marrow, AVN
	Ax (small-FOV)	2500	30	–	3–4	160–180	320	Symptomatic hip
fat-sat	Cor (small-FOV)	3000	60	–	3–4	160–180	288	Labrum, effusion

FAI / labral0/4

Radial reformats around the femoral neck are key.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Obl-Ax	2500	30	–	2–3	160	320	Along femoral neck — alpha angle (cam)
radial	Radial	2500	30	–	3	160	320	Acetabular clock-face labrum
fat-sat	Cor/Ax	3000	60	–	3	160–180	288	Chondrolabral
fat-sat, arthrography (optional)	3 planes	500–700	min	–	3	160	320	Dilute Gd ~2 mmol/L distension

ACR MSK.³³

Wrist

Routine0/4

Smallest FOV in MSK. ACR max 3 mm / 0.3 mm².

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Cor-obl	500–600	min	–	2–3 / 0.2	80–100	256–320	SL ligament, marrow; ~0.3 mm
fat-sat	Cor-obl	2500–3000	40	–	2–3	80–100	256–320	TFCC, ligaments
fat-sat	Ax	2500	40	–	3	80–100	256	Tendons, carpal tunnel
fat-sat	Cor	3000	60	–	2–3	80–100	256	Oedema

ACR MSK.³³

Arthrography (TFCC / instability)0/3

Three-compartment injection for intrinsic ligament / TFCC tears.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
fat-sat	Cor	500–600	min	–	2	80–100	320	Dilute Gd; TFCC / ligaments
fat-sat	Ax	500–600	min	–	2–3	80–100	256	–
or 3D GRE	Cor 3D	1000	min	–	0.4 iso	90	320	Intrinsic ligaments

Ankle & foot

Ankle (routine)0/4

Dixon efficient; oblique planes for ATFL. Ankle has no dedicated ACR table.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	500–700	12	–	3 / 0.3	140–160	320	Marrow, tendons
fat-sat	Ax	3000	40	–	3	140–160	288	Tendons, ligaments (ATFL obl)
fat-sat	Sag	3000	40	–	3	140–160	288	Achilles, plantar fascia
fat-sat	Cor	3000	60	–	3	140–160	288	Osteochondral, ligaments

Forefoot (Morton / plantar plate)0/4

Planes prescribed relative to the metatarsals. ACR forefoot 3 mm / 0.4 mm².

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
fat-sat, short-axis	Short-ax	3000	60	–	3 / 0.3	100–120	256	⟂ metatarsals — Morton, plantar plate
short-axis	Short-ax	500	12	–	3	100–120	256	Neuroma (T1-iso), marrow
fat-sat, long-axis	Long-ax	3000	40	–	3	100–120	256	Plantar plate
fat-sat	Sag	3000	60	–	3	100–120	256	–

ACR MSK.³³

Techniques & whole-body

Fat suppression, 2D vs 3D & acceleration

Spectral fat-sat = best SNR but fails off-isocentre/near metal; STIR = most uniform; Dixon (increasingly default) gives water/fat/in/opposed in one acquisition.²³
2D FSE is the workhorse; 3D isotropic (SPACE/CUBE/VISTA/MVOX) gives sub-mm reformats — but ACR still requires each plane separately acquired.^24,25
DL-accelerated / abbreviated joint protocols validated with preserved accuracy.²⁸

Metal artifact reduction (MARS)0/3

Optimise first: high bandwidth, thin slices + large matrix, short TE, FSE/TSE + STIR (avoid GRE near metal).

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Cor/Ax	4000	30	150	3–4	per joint	320	High BW 400–540 Hz/px; STIR not spectral FS
VAT / SEMAC	per joint	600	min	–	3–4	per joint	320	View-angle tilt; SEMAC-CS through-plane
SEMAC / MAVRIC-SL	per joint	4000	80	–	3–4	per joint	256	3D multispectral

Skeletal Radiology 2024; MAVRIC-SL 2025.^29,30

Whole-body (MY-RADS / MET-RADS-P)0/3

Myeloma / metastatic prostate; overall quality is usually limited by DWI quality.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
multi-station	Ax	long	min	STIR	5–6	multi	128	b50–100 & 800–900; ADC
T1, multi-station	Ax	min	dual-echo	–	5–6	multi	256	Water/fat/in/opposed
and T2 FSE/STIR	Sag	600	12	–	4	whole spine	384	Whole spine

MY-RADS.³²

Pediatric

Smaller FOV, child-sized coils, higher relative resolution; shorter protocols reduce sedation.³⁴
JIA: fluid-sensitive FS/STIR + T1; fat-sat T1 post-Gd within ~5–10 min for enhancing synovitis; DWI emerging as a non-contrast biomarker.^35,36
Normal physes / red marrow can mimic pathology — pair fluid-sensitive FS with a fat-sensitive (T1/Dixon) sequence.

Body & oncology

Structured systems (PI-RADS, LI-RADS, MY-RADS) specify acquisition and interpretation. Screening/surveillance uses biparametric or abbreviated, contrast-sparing protocols — listed separately in full.

High-Yield Pearls — body & oncology

Structured systems define both acquisition and interpretation: PI-RADS v2.1 (prostate), LI-RADS (liver), VI-RADS (bladder), O-RADS (ovary), ccLS (renal), MY-RADS (whole-body).
Prostate: mpMRI = T2 + DWI (high b ≥1400) + DCE (≤15 s temporal); biparametric screening (PRISM) drops contrast and the endorectal coil.
Liver: extracellular agent for the dynamic study; gadoxetate adds a ~20-min hepatobiliary phase; abbreviated non-contrast (T2 + DWI) for HCC surveillance.
Breast: image on days 7–14 of the cycle to lower background enhancement; Kuhl abbreviated (FAST, ~3 min) approaches full-protocol accuracy.
Rectal (ESGAR): high-resolution oblique T2 ⊥ the tumour; DWI is integral to restaging (residual tumour vs fibrosis); no routine DCE.
Chemical shift (in/opposed-phase): adrenal adenoma if signal-intensity index >16.5%; also detects microscopic fat in renal masses (ccLS).
Obstetric/fetal & PAS: 1.5 T, no contrast, no sedation; single-shot T2 is the workhorse; placenta accreta uses the 7 SAR–ESUR features.

Prostate

mpMRI (PI-RADS v2.1)0/4

3T preferred, 1.5T acceptable; endorectal coil optional.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Ax obl	3000–5000	100–120	–	3 / 0	120–200	320–384	+ sag/cor; ~0.4–0.7 mm; zonal anatomy
	Ax	3000–5000	min	–	3–4	200–220	96–128	b0-100, 800-1000 + high b≥1400 (acq/calc); ADC
DCE	Ax 3D	min	min	–	3	200–220	192	Temporal res ≤15 s; post-Gd
	Ax	500–700	10	–	4–5	300–360	256	Haemorrhage, nodes, bone

PI-RADS v2.1.³⁷

Screening bpMRI (PRISM)New0/2

PRISM (JAMA Oncology, June 2026): no contrast, no endorectal coil; stage-gated 2-step read; ≤15 min.

✓	Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
		Ax + 1 ortho	3000–5000	100–120	–	3 / 0	120–200	320	≤15 min total
		Ax	3000–5000	min	–	3–4	200–220	96–128	b0/800 + high ~b1500; ADC

PRISM; PI-QUAL v2.^38,39,40

Liver

Full diagnostic (extracellular agent)0/4

Multiphasic dynamic; chemical-shift for steatosis/iron.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
in/opposed-phase	Ax 3D	min	dual-echo	–	3–4	360–420	256	Chemical shift
± fat-sat	Ax/Cor	1500–2500	80–100	–	5–6	360–420	320	Lesion characterisation
	Ax	long	min	–	5–6	360–420	128	b0/50, 400–500, 800; ADC
dynamic post-Gd fat-sat	Ax 3D	min	min	–	3	360–420	256	Late arterial / PV / delayed

LI-RADS 2024.^41,42

Gadoxetate (hepatobiliary)0/5

Add hepatobiliary phase ~20 min post-injection.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
in/opposed-phase	Ax 3D	min	dual-echo	–	3–4	360–420	256	Chemical shift
± fat-sat	Ax	1500–2500	80–100	–	5–6	360–420	320	–
	Ax	long	min	–	5–6	360–420	128	b0/50, 400, 800; ADC
dynamic post-Gd	Ax 3D	min	min	–	3	360–420	256	Arterial / PV / transitional
hepatobiliary phase	Ax 3D	min	min	–	3	360–420	256	~20 min post-injection

LI-RADS; AMRI.^41,43

Abbreviated (non-contrast surveillance)0/2

Non-contrast HCC surveillance ~10 min.

✓	Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	± fat-sat	Ax	1500	90	–	5–6	380	256	Surveillance
		Ax	long	min	–	5–6	380	128	b0/500/800; ADC

AMRI.⁴³

Breast

Full dynamic0/4

Days 7–14 of cycle (premenopausal) to minimise background parenchymal enhancement.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
pre, fat-sat	Ax 3D	min	min	–	≤1–1.5	320–360	384	Bilateral high-res
dynamic post ×4–5, fat-sat	Ax 3D	min	min	–	≤1–1.5	320–360	384	≤60–90 s/phase; subtraction + MIP; kinetics
	Ax	3000–4000	90	–	3–4	320–360	384	Cysts, oedema
	Ax	long	min	–	4	320–360	128	b0/800; SPAIR; adjunct

EUSOBI; DWI WG.^44,46

Abbreviated (Kuhl FAST)0/3

~3 min; diagnostic accuracy ≈ full protocol.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
pre, fat-sat	Ax 3D	min	min	–	≤1.5	320–360	384	–
1st post, fat-sat	Ax 3D	min	min	–	≤1.5	320–360	384	Single post; subtraction + MIP
optional	Ax	3000	90	–	4	320–360	320	± DWI

Kuhl FAST.⁴⁵

Rectum

Primary staging0/4

No routine DCE; spasmolytic optional.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	3000–4000	100	–	3	200–240	320	Planning
high-res	Obl-Ax	3000–4000	100	–	3 / 0	160–200	320–512	⟂ tumour; mrT, mrCRM, EMVI; <1 mm
high-res	Obl-Cor	3000	100	–	3	160–200	320	Low tumours / anal canal
	Ax	long	min	–	3–4	200–240	128	b0/800–1000; nodes

ESGAR/Radiology Assistant.⁴⁷

Restaging (post-neoadjuvant)0/2

DWI integral to distinguishing residual tumour from fibrosis.

✓	Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	high-res	Obl-Ax	3000–4000	100	–	3	160–200	320–512	Fibrosis vs tumour
		Ax	long	min	–	3–4	200–240	128	High b — residual tumour

ESGAR Part II.⁴⁷

Pancreas & biliary

MRCP (standard)0/4

Heavily T2W; static bile/pancreatic fluid bright.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Cor obl 3D	resp-trig	500–700	–	1–1.5 iso	300–360	320	MIP / reformats
	Cor radial	–	800–1000	–	40–60 slab	300	256	Quick overview
	Ax/Cor	–	90	–	4–5	320–380	256	Parenchyma, ducts
± post-Gd	Ax 3D	min	min	–	3	360	256	If mass/inflammation

ABC of MRCP.⁴⁸

Secretin-enhanced MRCP0/2

IV secretin stimulates exocrine flow — duct dynamics / compliance.

✓	Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	serial	Cor slab	–	800–1000	–	40–50 slab	300	256	Serial ~10–15 min post-secretin
		Cor obl 3D	resp-trig	600	–	1–1.5 iso	320	320	Baseline anatomy

Secretin-MRCP.⁴⁸

Small bowel

MR enterography (standard)0/5

~1–1.5 L oral contrast for distension + antiperistaltic agent.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Cor + Ax	–	90	–	4–5	380–420	256	± fat-sat; distension
	Cor + Ax	min	min	–	4–5	380–420	256	Wall, mesentery
	Ax	long	min	–	5	380–420	128	b0/800; inflammation
motility	Cor	min	min	–	8–10	400	192	~20 s/level
dynamic post-Gd fat-sat	Ax 3D	min	min	–	3	380–420	256	Enteric-phase mural enhancement

SAR consensus.⁴⁹

Abbreviated (non-contrast)0/3

≤5 sequences, <12 min room time, no IV contrast.

Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
Cor + Ax	–	90	–	4–5	380–420	256	± fat-sat
Cor	min	min	–	4–5	400	256	Wall
Ax	long	min	–	5	400	128	b0/800

Abbreviated MRE.⁴⁹

Adrenal

Adrenal mass (adenoma vs non-adenoma)0/4

Chemical-shift (in/opposed-phase) is the workhorse: intracellular-lipid signal drop-out on opposed-phase → lipid-rich adenoma (signal-intensity index >16.5%, or visual dropout vs spleen). Lipid-poor/indeterminate → dynamic post-Gd (or CT washout). DWI does not reliably separate adenoma from malignancy.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
chemical shift	Ax	min	in ~4.4 / opp ~2.2	–	4–5	320–400	256	Adenoma drop-out; SI index >16.5%
± fat-sat	Ax/Cor	1500–2500	90	–	4–5	320–400	256	Cyst, phaeo (light-bulb), necrosis
dynamic post-Gd, fat-sat	Ax 3D	min	min	–	3	320–400	224	Lipid-poor / indeterminate; phaeo, ACC, mets
adjunct	Ax	long	min	–	5	320–400	128	b0/800; does not separate adenoma vs malignancy

ACR incidental adrenal white paper; chemical-shift MR.^78,79

Kidney

Solid renal mass (ccLS)ccLS0/4

Clear-cell Likelihood Score (ccLS 1–5) for indeterminate small (cT1) solid renal masses. Three core features: T2 signal of the enhancing tissue, corticomedullary-phase enhancement, and microscopic fat (in/opposed-phase drop-out); DWI and macroscopic fat are adjuncts. Subtraction confirms true enhancement.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Ax + Cor	2000–4000	90	–	3–4	320–380	320	Predominant T2 signal of enhancing tissue
chemical shift	Ax	min	dual-echo	–	3–4	320–380	256	Microscopic (intracellular) fat drop-out
	Ax	long	min	–	4–5	320–380	128	b0/800; adjunct feature; ADC
multiphase post-Gd, fat-sat	Ax/Cor 3D	min	min	–	3	320–380	224	Corticomedullary (key) / nephrographic / excretory; subtraction

ccLS (Radiology, How We Do It).⁸⁰

Bladder

Bladder cancer (VI-RADS)VI-RADS0/3

VI-RADS (1–5) predicts detrusor (muscularis propria) invasion. Moderate bladder distension; image before biopsy/TURBT or ≥2 weeks after. T2 (structural) + DWI + DCE combine into the score; DWI is the dominant sequence.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
high-res, small-FOV	Ax + Sag + Cor	3000–5000	100	–	3–4	200–250	320–384	Muscularis propria integrity; VI-RADS structural
dominant	Ax (± Sag)	long	min	–	3–4	200–250	128	b0/800–1000 + calc b1400–2000; stalk/interface
DCE	Ax (± Sag) 3D	min	min	–	≤3	220–260	224	~30 s temporal; early tumour vs muscle enhancement

VI-RADS (Panebianco, Eur Urol 2018).⁸¹

Anal fistula

Perianal fistula (St James)0/5

Small-FOV centred on the anal canal; plane axial- and coronal-oblique orthogonal/parallel to the canal. St James grade 1–5 (intersphincteric → trans-sphincteric → supralevator, ± abscess/secondary tracks) + active vs fibrotic (T2/STIR-bright + enhancement = active). No luminal contrast needed.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
high-res, small-FOV	Ax-obl + Cor-obl	3000–4000	90	–	3 / 0	180–220	320	Tract, internal opening, sphincter relation (St James)
	Ax-obl + Cor-obl	3000–4000	90	150–180	3	180–220	320	Active tract/abscess bright; secondary extensions
	Ax-obl	500–700	10	–	3–4	200–240	256	Anatomy, ischioanal fat planes
	Ax	long	min	–	4	200–240	128	b0/800; abscess restricts; adjunct to post-Gd
	Ax-obl + Cor-obl	min	min	–	3	180–220	256	Active (enhancing) vs fibrotic; abscess wall

MRI of perianal fistulas (RadioGraphics 2025).⁸²

Gynecologic / pelvis

Endometrial cancer0/5

ESUR 2025, aligned to 2023 FIGO.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	3000–4000	100	–	3–4	200–240	320	–
small-FOV, short-axis uterus	Obl	3000	100	–	3–4	200–240	320	Myometrial invasion
	Ax obl	long	min	–	3–4	220–260	128	b0/800–1000
DCE	Sag 3D	min	min	–	3	240	224	Invasion depth (equilibrium)
	Ax	500	10	–	5	320	256	Nodes

ESUR endometrial.⁵⁰

Cervical cancer0/4

T2 + DWI for staging/response/recurrence; DCE optional.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	3000–4000	100	–	3–4	200–240	320	–
small-FOV ⟂ cervix	Obl-Ax	3000	100	–	3–4	180–220	320	Parametrial invasion
	Ax obl	long	min	–	3–4	220–260	128	b0/800–1000
DCE optional	Sag 3D	min	min	–	3	240	224	Research / recurrence

ESUR cervical.⁵¹

Ovarian / adnexalO-RADS0/5

O-RADS MRI risk score from solid-tissue enhancement — DCE time-intensity curve (low / intermediate / high) vs the outer myometrium; a non-DCE pathway uses delayed post-contrast enhancement relative to myometrium.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
small-FOV	Sag + Ax + Cor	3000–4000	100	–	3–4	200–240	320	Solid tissue, locules, fat/fibrous
	Ax	500–700	10	–	4–5	300–340	256	Fat vs blood (pair with FS)
fat-sat	Ax	500–700	10	–	4–5	300–340	256	Endometrioma/haemorrhage vs fat
	Ax	long	min	–	4–5	300–340	128	b0/800–1000; solid components
DCE	Ax 3D	min	min	–	≤3	240–300	224	15 s temporal, start 30 s pre-Gd, 4 min; TIC vs myometrium

O-RADS MRI (ACR).⁶⁹

Endometriosis (deep pelvic)0/4

ESUR 2025: fasting + antiperistaltic agent, moderate bladder filling, ± bowel / vaginal-rectal opacification; compartment-based reporting; T1 fat-sat is key to confirm haemorrhagic foci.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
high-res, multiplanar	Sag + Ax + Cor	3000–4000	100	–	3–4	200–250	320–384	DIE: uterosacrals, torus, pouch of Douglas, rectovaginal
	Ax	500–700	10	–	4–5	300–340	256	Baseline
fat-sat	Ax (± Sag)	500–700	10	–	4–5	300–340	256	Confirm blood products (T1-bright persists)
cover kidneys	Cor	3000	100	–	4–5	350–400	320	Ureteric involvement / hydronephrosis

ESUR endometriosis 2025.⁷⁰

Fibroids / adenomyosis0/5

ESUR leiomyoma: pre-uterine-artery-embolisation map — fibroid number/size/FIGO location + enhancement (viability); report coexisting adenomyosis (junctional zone >12 mm; affects UAE outcome).

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Sag	3000–4000	100	–	4	240–280	320	Fibroid map (FIGO), junctional zone
	Ax	3000–4000	100	–	4	240–280	320	Number, size, location
	Ax	500–700	10	–	5	300–340	256	Haemorrhagic/red degeneration
	Ax	long	min	–	4–5	300	128	b0/800; atypical/rapid-growth (sarcoma caution)
DCE / post-Gd	Sag + Ax 3D	min	min	–	3	260–300	224	Viability — pre-UAE (non-enhancing = poor target); ovarian supply

ESUR leiomyoma.⁷¹

Placenta accreta spectrum0/3

Obstetric, usually 3rd trimester; NO gadolinium; moderate bladder filling. SAR–ESUR 7 MRI features: dark intraplacental T2 bands, placental bulge, myometrial thinning, bladder-wall interruption, focal exophytic mass, abnormal vascularity, heterogeneity.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
T2, heavily-weighted	Sag + Ax + Cor	–	90	–	4	300–400	256	No contrast; dark T2 bands, bulge, myometrial thinning
	Sag + Ax	min	min	–	4	300–400	256	Uterine/bladder interface, serosa
optional	Ax	long	min	–	5	350–400	128	Optional — placental boundary delineation

SAR–ESUR PAS consensus.⁷²

Bowel / acute abdomen

Appendicitis (non-contrast)0/5

US-first; MRI when ultrasound is inconclusive — the imaging of choice in pregnancy and often in children (no ionising radiation). 1.5 T preferred (limits fetal heating); no oral/IV contrast. Positive: dilated (>7 mm) blind-ending tubular structure, wall oedema, periappendiceal fluid/fat stranding, restricted diffusion.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Ax + Cor	–	90	–	4–5	300–360	256	Large-FOV survey; blind-ending tube
fat-sat / STIR	Ax + Cor	–	90	150–180	4–5	300–360	256	Periappendiceal fluid, fat stranding
in/opposed-phase	Ax	min	dual-echo	–	3–4	320–380	256	Appendicolith, blood, fat planes (no Gd)
	Ax	long	min	–	4–5	300–360	128	b0/800; inflamed wall, abscess
optional	Cor	min	min	–	4–5	320–380	256	Motion-robust; free fluid, bowel

ACR AC Right Lower Quadrant Pain 2022; MR appendicitis in pregnancy.^73,74

Acute abdomen in pregnancy0/6

Non-contrast maternal survey for non-obstetric acute abdomen/pelvis — appendicitis, cholecystitis/choledocholithiasis, adnexal torsion, ovarian-vein thrombosis, urolithiasis/hydronephrosis, bowel obstruction. 1.5 T; multiplanar; add thick-slab MRCP if biliary.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Ax + Cor + Sag	–	90	–	4–5	350–400	256	Diaphragm→pubis survey; fluid/oedema
fat-sat / STIR	Ax + Cor	–	90	150–180	4–5	350–400	256	Inflammation, oedema
in/opposed-phase	Ax	min	dual-echo	–	3–4	350–400	256	Blood, fat, adrenal; no Gd
	Ax	long	min	–	5	350–400	128	b0/800; abscess, torsion, bowel
	Cor + Ax	min	min	–	4–5	380–420	256	Bowel, ovarian vein, free fluid
if biliary	Cor radial	–	800–1000	–	40–60 slab	300	256	Choledocholithiasis / CBD

MR acute abdomen in pregnancy (RadioGraphics).⁷⁴

Obstetric / fetal

Fetal MRI (brain ± body)0/5

Complementary to neurosonography; 1.5 T standard (3 T acceptable — ACR–SPR: minimal fetal risk); NO contrast, NO maternal sedation. Single-shot T2 is the workhorse, re-planned to fetal anatomy for every stack; keep SAR in normal operating mode and minimise scan time.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
workhorse	3 planes to fetal brain	–	90–140	–	3–4 / 0	small (fetal head)	256	Re-plan each stack; cortex, ventricles, posterior fossa
	3 planes to fetal body	–	90	–	3–4	fetal trunk	256	Thorax/abdomen, lung signal, GI
	Multiplanar	min	min	–	3–4	fetal	256	Heart/vessels, spine; motion-robust
	Ax	min	min	–	4–5	fetal	192	Fat, meconium (bowel), haemorrhage, thyroid/liver
	Ax	long	min	–	4–5	fetal	128	b0/600–700; brain injury (ADC), blood/mineral (EPI/T2*)

ACR–SPR fetal MRI parameter; ISUOG fetal MRI 2023.^75,76

Pediatric

Free-breathing with respiratory navigators/triggering; motion-robust radial acquisitions; feed-and-wrap for infants.⁵²
DL / compressed-sensing acceleration; DL low-dose gadolinium reconstruction to cut contrast burden.
Paediatric IBD MRE: non-contrast / abbreviated protocols + DWI to avoid repeated gadolinium.

Pregnancy

MRI is preferred over CT for non-obstetric acute abdomen/pelvis and may be performed in any trimester when clinically indicated — no proven harm at 1.5 T or 3 T.³
Avoid gadolinium unless essential: GBCAs cross the placenta and have been associated with rare adverse fetal/childhood outcomes (stillbirth/neonatal death, inflammatory/infiltrative skin conditions).⁷⁷
No routine sedation or fasting (unless MRCP); left-lateral decubitus in the 3rd trimester to relieve IVC compression; keep SAR in normal operating mode and minimise acoustic noise and scan time.

Cardiac & vascular

Modular, indication-based (SCMR). Heart protocols are assembled per clinical question; mapping and iron thresholds need local reference ranges.

High-Yield Pearls — cardiac & vascular

Modular SCMR protocols are assembled per clinical question; cine bSSFP is the functional backbone for volumes and wall motion.
Ischaemia: vasodilator (adenosine) stress-first perfusion, then rest; LGE for viability/scar (TI ~300–420 ms, 10–20 min post-Gd; PSIR is less TI-sensitive).
Tissue characterisation: native/post T1 & T2 mapping with ECV — always interpret against local reference ranges.
Myocarditis (2018 Lake Louise): one T2-based plus one T1-based criterion.
Iron (T2*): mid-septal short-axis ROI; >20 ms normal, <10 ms severe (10–20 ms mild–moderate).
MRA: first-pass CE-MRA with bolus timing; QISS or ferumoxytol for non-contrast MRA when GBCA is contraindicated.

Heart

Function / ischaemia0/3

Stress first, then ≥10 min before rest; add LGE for viability.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	SA stack + 2/3/4-ch	~3	~1.4	–	6–8 / 2	340–380	~1.8 mm	Function/volumes; ~35–50 ms/phase
vasodilator stress	3 × SA	~2	~1	sat-recovery	8–10	340	128	Adenosine; ~0.05–0.075 mmol/kg first-pass
	SA + LAX	R-R	~3	300–420	6–8	340	192	10–20 min post-Gd; PSIR less TI-sensitive

SCMR protocols; cine/LGE params; 2025 perfusion consensus.^53,54,58

Cardiomyopathy0/4

Native T1 ~950–1050 ms (1.5T) / ~1150–1200 ms (3T) — use local normals.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	SA + LAX	~3	~1.4	–	6–8	340–380	~1.8 mm	Function, wall thickness
native + post	SA basal/mid/apical	MOLLI	~1	scheme	8	340	160	ECV with haematocrit
	SA	–	multi	–	8	340	160	Oedema
	SA + LAX	R-R	~3	300–420	6–8	340	192	Mid-wall/patchy = non-ischaemic

SCMR/EACVI mapping.^55,56

Myocarditis0/4

Updated (2018) Lake Louise: one T2-based + one T1-based criterion.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	SA + LAX	~3	~1.4	–	6–8	340	~1.8 mm	Function, pericardium
	SA	–	multi	–	8	340	160	Oedema (T2 criterion)
native + post / ECV	SA	MOLLI	~1	scheme	8	340	160	T1 criterion
	SA + LAX	R-R	~3	300–420	6–8	340	192	Non-ischaemic pattern

Lake Louise 2018.⁵⁷

Iron overload (T2*)0/3

Cardiac T2* is the gold standard for myocardial iron.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
septal ROI	Mid-SA	–	multi (2–18 ms)	–	8–10	340	160	R2=1000/T2; >20 ms normal, <10 severe
	SA + LAX	~3	~1.4	–	6–8	340	~1.8 mm	Function
liver	Ax (liver)	–	multi	–	10	380	160	LIC calibration (method-dependent)

T2* thresholds.⁶³

Vessels (MRA)

CE-MRA0/3

General-purpose default; carotid, aorta, peripheral runoff.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Cor 3D	min	min	–	1–1.5	per station	~1 mm	First-pass Gd; test bolus / bolus tracking
time-resolved	Cor 3D	min	min	–	1.5–2	per station	~1.5 mm	Dynamic (TWIST/TRICKS/4D-TRAK)
optional supplement	Ax 3D	20–25	3–7	–	0.6–1	200	320	Carotid / intracranial

CE-MRA vs TOF.^60,61

Non-contrast MRA0/3

When gadolinium is contraindicated. Ferumoxytol steady-state (off-label) for infants/small vessels.

Sequence	Plane	TR	TE	TI	Slice/gap	FOV	Matrix/res	Other
	Ax/Cor ECG-gated	R-R	min	quiescent	2–3	per station	~1 mm	Peripheral runoff; renal-safe
	Ax 3D	20–25	3–7	–	0.6–1	200	320	Carotid / intracranial
navigator, TSLIP	Cor	min	min	inversion	1.5–2	300	~1.3 mm	Renal / aorta

QISS; non-contrast; ferumoxytol.^60,61,62

Pediatric

Free-breathing, navigator & DL-accelerated cine replace multiple breath-holds; validated in children (2025–2026).⁶⁴
Ferumoxytol for CE-MRA / 4D flow in infants and small-caliber low-flow vessels, outperforming gadolinium under anesthesia.⁶⁵
4D flow suits complex CHD anatomy; use pediatric resolution (2–2.5 mm³).⁵⁹

MRI Patient Positioning — Quick Reference

Positioning, coil selection, centring landmarks, breathing strategy and comfort/immobilisation for common MRI exams, grouped by region. Expand a region to see the exam cards. Local protocols and coil availability vary — always follow your department’s SOP and manufacturer guidance.

Neuro7 exams

Brain (routine)

Position: Supine, head-first, arms by sides.
Coil: Head / head-neck array.
Landmark / centring: Centre on nasion (glabella); align canthomeatal line.
Breathing: n/a (still).
Immobilisation / comfort: Head cushions, forehead strap, ear plugs + defenders.
Tips / common errors: Keep head straight — rotation skews symmetric structures; pad to reduce motion.

Brain — epilepsy / hippocampal

Position: Supine, head-first, arms by sides.
Coil: Head / head-neck array.
Landmark / centring: Centre on nasion; angle obliques perpendicular to long axis of hippocampus.
Breathing: n/a.
Immobilisation / comfort: Head cushions, strap, hearing protection.
Tips / common errors: Prescribe thin coronal obliques ⟂ hippocampus; minimise head tilt for symmetry.

IAMs / CP angle

Position: Supine, head-first, arms by sides.
Coil: Head / head-neck array.
Landmark / centring: Centre on nasion; thin axial + high-res T2 through IACs.
Breathing: n/a.
Immobilisation / comfort: Head cushions, strap, ear protection.
Tips / common errors: Small FOV thin slices through IACs; symmetry critical for VII/VIII.

Pituitary / sella

Position: Supine, head-first, arms by sides.
Coil: Head array.
Landmark / centring: Centre on nasion; small-FOV coronal + sagittal through sella.
Breathing: n/a; dynamic post-contrast timing if microadenoma.
Immobilisation / comfort: Head cushions, strap, ear protection.
Tips / common errors: Thin (2–3 mm) coronal dynamic; time contrast for microadenoma.

Orbits

Position: Supine, head-first, eyes closed, gaze fixed straight ahead.
Coil: Head array (small surface coil optional).
Landmark / centring: Centre on orbits; fat-sat T2/T1 small FOV.
Breathing: n/a — instruct patient to keep eyes still.
Immobilisation / comfort: Head cushions, strap, ear protection.
Tips / common errors: Eyes still reduces motion blur; use fat suppression for orbital fat.

MRA — Circle of Willis

Position: Supine, head-first, arms by sides.
Coil: Head / head-neck array.
Landmark / centring: Centre on nasion; 3D TOF slab over circle of Willis.
Breathing: n/a.
Immobilisation / comfort: Head cushions, strap, ear protection.
Tips / common errors: Position slab low enough to capture terminal ICA/vertebrobasilar; no contrast for TOF.

Carotid MRA (neck)

Position: Supine, head-first, chin slightly extended, arms by sides.
Coil: Head-neck / neck array.
Landmark / centring: Centre on thyroid cartilage; coronal CE-MRA aortic arch → circle of Willis.
Breathing: Suspend breathing briefly for arch acquisition.
Immobilisation / comfort: Neck support, strap, ear protection.
Tips / common errors: Time the contrast bolus for arterial phase; cover arch to intracranial ICA.

Spine4 exams

Cervical spine

Position: Supine, head-first, arms by sides, shoulders down.
Coil: Head-neck + spine array.
Landmark / centring: Centre on thyroid cartilage (~C4).
Breathing: n/a; quiet breathing.
Immobilisation / comfort: Neck cushion, knee bolster, strap, ear protection.
Tips / common errors: Pull shoulders down to reduce brachial-plexus wrap; saturate swallowing motion.

Thoracic spine

Position: Supine, head-first, arms by sides.
Coil: Spine array (± body array).
Landmark / centring: Centre at mid-sternum (~T6); count from C7 or L5 to level.
Breathing: Quiet breathing.
Immobilisation / comfort: Knee bolster, strap, ear protection.
Tips / common errors: Use a vitamin-E/skin marker or count vertebrae to confirm level.

Lumbar spine

Position: Supine, head-first, knees flexed over bolster.
Coil: Spine array.
Landmark / centring: Centre on iliac crest (~L4).
Breathing: Quiet breathing.
Immobilisation / comfort: Large knee bolster (flattens lordosis), strap, ear protection.
Tips / common errors: Knee bolster reduces lordosis & back pain; sagittal to count levels.

Whole spine

Position: Supine, head-first, arms by sides.
Coil: Head-neck + full spine array (multi-station).
Landmark / centring: Centre first station at orbit; step-table sagittal C-to-sacrum.
Breathing: Quiet breathing.
Immobilisation / comfort: Neck + knee support, strap, ear protection.
Tips / common errors: Composed multi-station sagittal; keep spine straight for stitching.

MSK10 exams

Shoulder

Position: Supine, head-first, affected arm at side, hand supinated (palm up), slight external rotation.
Coil: Dedicated shoulder / flexible surface coil.
Landmark / centring: Centre on humeral head / coracoid; small FOV.
Breathing: n/a.
Immobilisation / comfort: Sandbag/strap on hand to hold external rotation, ear protection.
Tips / common errors: External rotation opens the joint; feet-first if narrow shoulders/claustrophobia.

Elbow

Position: Prone, arm extended overhead “superman” (or supine at side), thumb up.
Coil: Extremity / flexible surface coil.
Landmark / centring: Centre on olecranon / joint line.
Breathing: n/a.
Immobilisation / comfort: Foam pads around elbow, strap, ear protection.
Tips / common errors: Superman position centres elbow in bore; at-side alternative for large/older patients.

Wrist

Position: Prone, arm overhead “superman”, wrist pronated, or at side.
Coil: Wrist / small extremity coil.
Landmark / centring: Centre on radiocarpal joint.
Breathing: n/a.
Immobilisation / comfort: Foam pads, strap, ear protection.
Tips / common errors: Keep wrist in coil isocentre; superman reduces off-centre artefact.

Hand / fingers

Position: Prone, arm overhead “superman”, palm down on coil.
Coil: Small flexible / extremity coil.
Landmark / centring: Centre on metacarpals / affected digit.
Breathing: n/a.
Immobilisation / comfort: Pads to immobilise fingers, strap, ear protection.
Tips / common errors: Immobilise digit; place ROI at isocentre for small FOV/high resolution.

Hip (single)

Position: Supine, feet-first, legs straight, feet gently internally rotated & taped.
Coil: Body / flexible array over hip.
Landmark / centring: Centre on femoral head (~2 cm below ASIS line).
Breathing: Quiet breathing.
Immobilisation / comfort: Foot tape for internal rotation, knee support, ear protection.
Tips / common errors: Internal rotation of foot elongates femoral neck; contralateral hip for AVN compare.

Pelvis / SIJ

Position: Supine, feet-first, legs straight.
Coil: Body + spine array.
Landmark / centring: Centre midway between ASIS and pubic symphysis; oblique coronals along sacrum for SIJ.
Breathing: Quiet breathing.
Immobilisation / comfort: Knee support, strap, ear protection.
Tips / common errors: For SIJ prescribe semi-coronal oblique parallel to sacrum; fat-sat for oedema.

Knee

Position: Supine, feet-first, knee slightly flexed (~10–15°) & externally rotated ~15°.
Coil: Dedicated knee (HD) coil.
Landmark / centring: Centre on inferior pole of patella / joint line.
Breathing: n/a.
Immobilisation / comfort: Knee coil, foam wedge, strap, ear protection.
Tips / common errors: Slight external rotation aligns ACL for sagittal obliques; feet-first eases claustrophobia.

Ankle

Position: Supine, feet-first, ankle in neutral 90° dorsiflexion.
Coil: Ankle / foot (extremity) coil.
Landmark / centring: Centre on medial malleolus / tibiotalar joint.
Breathing: n/a.
Immobilisation / comfort: Coil + pads to hold 90°, strap, ear protection.
Tips / common errors: Neutral 90° avoids magic-angle on tendons; feet-first minimises bore travel.

Foot

Position: Supine, feet-first, foot in coil, toes up (or plantar per pathology).
Coil: Foot / extremity coil.
Landmark / centring: Centre on midfoot / affected region.
Breathing: n/a.
Immobilisation / comfort: Pads to immobilise, strap, ear protection.
Tips / common errors: Angle short-axis to metatarsals for forefoot; small FOV high resolution.

TMJ

Position: Supine, head-first, bite blocks for open/closed mouth series.
Coil: Bilateral small surface (TMJ) coils or head coil.
Landmark / centring: Centre on condyles; thin oblique sagittal ⟂ condylar axis.
Breathing: n/a.
Immobilisation / comfort: TMJ coils, bite block, head strap, ear protection.
Tips / common errors: Acquire closed then open (bite block) to assess disc position/reduction.

Body9 exams

Liver / MRCP

Position: Supine, head-first (or feet-first), arms above head.
Coil: Body array + spine array.
Landmark / centring: Centre on xiphisternum.
Breathing: Breath-hold in expiration; MRCP thick-slab often respiratory-triggered.
Immobilisation / comfort: Arms up on pads, strap, ear protection; belt for navigator.
Tips / common errors: Consistent expiration breath-holds; fast on secretin/fatty-meal per protocol.

Pancreas

Position: Supine, head-first, arms above head.
Coil: Body + spine array.
Landmark / centring: Centre on xiphisternum / L1 level.
Breathing: Breath-hold expiration; dynamic post-contrast phases.
Immobilisation / comfort: Arms up, strap, ear protection.
Tips / common errors: Thin axial dynamic for lesion conspicuity; consistent breath-hold timing.

Adrenals

Position: Supine, head-first, arms above head.
Coil: Body + spine array.
Landmark / centring: Centre on xiphisternum / upper abdomen.
Breathing: Breath-hold expiration.
Immobilisation / comfort: Arms up, strap, ear protection.
Tips / common errors: In/opposed-phase chemical shift for adenoma signal drop.

Kidneys / MR urography

Position: Supine, head-first, arms above head.
Coil: Body + spine array.
Landmark / centring: Centre midway xiphisternum–umbilicus.
Breathing: Breath-hold; heavily-T2 urography may be respiratory-triggered.
Immobilisation / comfort: Arms up, strap, ear protection; hydration ± furosemide per protocol.
Tips / common errors: Coronal thick-slab T2 urography; dynamic excretory phase for collecting system.

Small bowel — MR enterography

Position: Supine or prone, head-first, arms above head; oral contrast pre-filled.
Coil: Body + spine array.
Landmark / centring: Centre on umbilicus.
Breathing: Breath-hold + free-breathing cine of loops; antiperistaltic agent given.
Immobilisation / comfort: Arms up, strap, ear protection.
Tips / common errors: Ensure adequate luminal distension (oral prep); prone can spread loops.

Rectum

Position: Supine, head-first, arms across chest or up; empty rectum ± gel.
Coil: Body / pelvic array (small FOV).
Landmark / centring: Centre on symphysis pubis; obliques ⟂ tumour axis.
Breathing: Quiet breathing; antiperistaltic agent.
Immobilisation / comfort: Knee support, strap, ear protection.
Tips / common errors: High-res T2 obliques ⟂ tumour long axis; no fat-sat for staging.

Prostate

Position: Supine, head-first, arms across chest.
Coil: Pelvic phased-array (endorectal rarely).
Landmark / centring: Centre on symphysis pubis.
Breathing: Quiet breathing; antiperistaltic agent to reduce rectal motion.
Immobilisation / comfort: Knee support, strap, ear protection.
Tips / common errors: Antispasmodic + empty rectum reduce motion/susceptibility on DWI.

Female pelvis

Position: Supine, head-first, arms across chest.
Coil: Pelvic phased-array (body + spine).
Landmark / centring: Centre on symphysis pubis; obliques along uterine/cervical axis.
Breathing: Quiet breathing; antiperistaltic agent.
Immobilisation / comfort: Knee support, strap, ear protection.
Tips / common errors: Align obliques to uterine axis (endometrium) or cervical canal per indication.

Breast

Position: Prone, head-first, both breasts pendant in coil apertures, arms up.
Coil: Dedicated breast coil (bilateral).
Landmark / centring: Centre on nipple line / mid-breast.
Breathing: Free-breathing; dynamic contrast subtraction.
Immobilisation / comfort: Prone breast coil, pads, strap, ear protection.
Tips / common errors: Ensure breasts fully pendant with no skin folds; symmetric positioning for subtraction.

Cardiac / vascular3 exams

Cardiac — function / viability

Position: Supine, head-first, arms above head; ECG leads placed.
Coil: Cardiac phased-array + ECG gating.
Landmark / centring: Centre on mid-sternum / left chest.
Breathing: Repeated breath-holds in expiration; ECG-gated cine.
Immobilisation / comfort: ECG electrodes, arms up, strap, ear protection.
Tips / common errors: Good ECG trace essential; consistent end-expiration breath-holds for slice registration.

Aorta MRA

Position: Supine, head-first, arms above head; ECG for root.
Coil: Body + spine array (± ECG).
Landmark / centring: Centre over region (arch/thoracic/abdominal).
Breathing: Breath-hold for thoracic; timed CE-MRA bolus.
Immobilisation / comfort: Arms up, strap, ear protection.
Tips / common errors: Time contrast to arterial phase; ECG-gate root for aortic-valve/dissection flap.

Peripheral run-off MRA

Position: Supine, feet-first, legs straight & together, feet padded.
Coil: Peripheral vascular array + body/spine (multi-station).
Landmark / centring: Centre first station at renal arteries; bolus-chase to feet.
Breathing: Suspend breathing for abdominal station.
Immobilisation / comfort: Legs strapped together, foot pads, ear protection.
Tips / common errors: Bolus-chase timing critical to avoid venous contamination distally.

Head & neck / other3 exams

Neck (soft tissue)

Position: Supine, head-first, arms by sides, shoulders down, neutral neck.
Coil: Head-neck / neck array.
Landmark / centring: Centre on thyroid cartilage / hyoid.
Breathing: Quiet breathing; suspend swallowing during acquisition.
Immobilisation / comfort: Neck support, strap, ear protection.
Tips / common errors: Ask patient not to swallow during scans; saturate to reduce swallowing motion.

Brachial plexus

Position: Supine, head-first, arms by sides, shoulders relaxed and down.
Coil: Head-neck + spine array.
Landmark / centring: Centre on lower neck (~C7/T1).
Breathing: Quiet breathing.
Immobilisation / comfort: Neck & shoulder support, strap, ear protection.
Tips / common errors: Coronal/oblique STIR along plexus; drop shoulders to include roots to cords.

Fetal MRI

Position: Supine (or left-lateral decubitus if supine hypotension), feet-first, arms up or by sides.
Coil: Body + spine array over gravid uterus.
Landmark / centring: Centre over uterus per gestation (fundal height).
Breathing: Free-breathing SSFSE single-shot (motion-robust); no breath-hold.
Immobilisation / comfort: Wedge under right hip if needed, strap, ear protection; reassure re: safety.
Tips / common errors: Use fast single-shot to freeze fetal motion; left-tilt avoids aortocaval compression.

Feet-first entry (knee, ankle, foot, lower-limb vascular, pelvis, hip) reduces bore travel and helps claustrophobic patients. Breath-holds are performed in expiration for consistent diaphragm position. Hearing protection is mandatory for every patient.

Phase-encode direction & saturation bands

Two levers that decide where artefacts land — not whether they exist. Ghosting from motion, pulsation and aliasing (wrap) is always mapped along the phase-encode (PE) axis; you rotate that axis, and drop saturation bands, to push those ghosts off the anatomy you care about. Conventions below are widely taught but vendor- and site-dependent — reason from the artefact source, don’t memorise blindly.

The three reasons you swap PE direction

Move motion/pulsation ghosts off the ROI. Ghosts propagate along PE. Put PE perpendicular to the line joining the pulsatile/moving source and the target (e.g. swap so vessel ghosts run head–foot along the spine, not across the cord).
Shorten the scan. Scan time = TR × phase steps × averages. Put the shorter anatomical dimension in phase and cut phase FOV (rectangular FOV) → fewer phase steps → faster. Frequency direction is “free.”
Avoid wrap (aliasing). Orient PE along the dimension that fits the FOV, or add phase oversampling / a sat band over the wrapping tissue.

Neuro

Exam / sequence	PE direction	Why	Example / swap
Axial brain T2 / FLAIR / T1	R ↔ L	L–R is the shorter dimension → rectangular FOV shortens scan; throws CSF & vascular pulsation ghosts side-to-side, away from brainstem & midline.	Swap to A–P if L–R wrap from broad shoulders/positioning.
Sagittal brain	S ↔ I (head–foot)	Keeps A–P vascular/CSF pulsation ghosts out of the sagittal display; foot–head fits the long axis.	A–P acceptable with flow comp.
Orbits (axial/coronal)	R ↔ L	Eye-motion ghosting travels with globe movement (up–down); PE R–L keeps that ghost off the globe & optic nerve.	Add flow comp + thin slices; ask patient to fixate gaze.
IAM / posterior fossa (axial)	R ↔ L	Displaces transverse sinus & basilar pulsation ghosts laterally, off the IACs / CP angle.	Flow comp on T2.
MRA / TOF	R ↔ L (axial slab)	Minimises pulsation ghost across the circle of Willis; combine with flow comp and a superior/inferior travelling sat for arterial vs venous selectivity.	Venous TOF → sat inferiorly; arterial → sat superiorly.

Axial-brain PE choice varies by vendor default (some ship A–P). The reasoning — shorter dimension + pulsation displacement — is what to teach.

Spine

Exam / sequence	PE direction	Why	Sat band
Sagittal C-spine	S ↔ I (head–foot)	Swallowing, pharyngeal motion and carotid pulsation are anterior; if PE were A–P their ghosts would project straight onto the cord. PE S–I runs those ghosts vertically instead.	Anterior sat over pharynx / great vessels.
Sagittal T- / L-spine	S ↔ I (head–foot)	Aortic/IVC pulsation and bowel/respiratory motion are anterior — same logic, keep their ghosts off the canal & cord/conus.	Anterior sat over aorta / bowel.
Axial C-spine	A ↔ P	Shorter neck dimension; combine with anterior sat to knock down swallowing ghost.	Anterior sat.
Axial L-spine	A ↔ P	Fits the FOV; anterior sat suppresses aortic pulsation projecting posteriorly onto discs/canal.	Anterior sat over aorta.

Body & pelvis

Exam / sequence	PE direction	Why	Sat / technique
Axial abdomen (liver, T2/T1)	A ↔ P	A–P is shorter → rectangular FOV; but respiratory ghost also runs A–P onto kidneys/liver — so pair with breath-hold or navigator, not just PE choice.	Breath-hold / respiratory triggering; anterior sat over subcut fat.
Axial abdomen with arm-down wrap	swap to R ↔ L or oversample	Arms in the FOV wrap along phase; oversample or move PE to the non-wrapping axis.	Phase oversampling / lateral sat.
Coronal abdomen/pelvis	R ↔ L	Shorter dimension coronally; keeps aortic pulsation ghost lateral.	Superior/inferior sat to cut in-flow artefact.
Prostate / rectum (axial T2)	R ↔ L	Displaces rectal-gas susceptibility & iliac vessel pulsation laterally, off the peripheral zone.	Anti-peristaltic (hyoscine/glucagon).
MRCP (coronal HASTE/3D)	R ↔ L	Keeps A–P respiratory/duodenal motion ghosts off the biliary tree.	Respiratory triggering + oral negative contrast.

Cardiac & vascular

Exam / sequence	PE direction	Why	Sat / technique
Cardiac cine / black-blood	A ↔ P (with fold suppression)	Chest wall & cardiac motion; PE choice + ECG gating keep ghosts off the myocardium.	Inferior/anterior sat to null in-flowing blood (black-blood double IR); ECG gating.
Contrast MRA	along shortest FOV dimension	Minimise phase steps for speed within the arterial bolus window.	No sat (want vessel signal); centric k-space ordering.

MSK

Exam / sequence	PE direction	Why	Swap / sat
Axial knee	R ↔ L	Popliteal artery is posterior & midline; PE R–L runs its pulsation ghost side-to-side, off the patellofemoral joint & menisci.	Add sat over popliteal vessels if ghost persists.
Sagittal / coronal knee	S ↔ I	Keeps popliteal pulsation ghost running head–foot, not across cruciates/menisci.	Flow comp on PD/T2.
Axial shoulder	A ↔ P	Axillary vessel pulsation runs off the glenoid/labrum; A–P fits the FOV.	Swap or sat if brachial pulsation crosses labrum.
Ankle / foot	S ↔ I or A ↔ P	Posterior tibial vessel pulsation; orient PE to keep ghost off the tibiotalar joint/tendons.	Anterior/posterior sat as needed.
Long-axis limbs / run-off	along limb axis	Fewer phase steps over the long, narrow FOV; keeps vessel ghosts running with the limb.	Travelling sat for run-off.

Saturation bands — types & placement

Spatial pre-sat A slab that tips & spoils signal from tissue before readout. Place it perpendicular to the flow/motion and between the source and the ROI — never overlapping the ROI. Uses: anterior sat (spine — swallowing, aortic/carotid pulsation, respiration); superior/inferior sat (null in-flowing arterial or venous blood; black-blood cardiac; venous vs arterial MRA selectivity); lateral sat (arm/fold suppression).
Travelling / tracking sat Moves with the slice through the volume — keeps flow suppression consistent across a stack (run-off MRA, TOF).
Chemical (fat) sat Frequency-selective, not spatial — nulls fat everywhere in the FOV (SPAIR/fat-sat). Distinct from spatial sat; combine both when needed.
Cost: each spatial sat pulse adds RF (SAR) and can reduce slices per TR; use the minimum that clears the artefact.

Reference values represent typical practice; always tailor to scanner, coil and patient. Educational content, not a substitute for your department’s validated protocols.

PACS: definitions, what to send & reformats

Getting the right images to the right place is part of the exam, not an afterthought. Below: what the archive tiers actually mean, the minimum series a radiologist expects for each body part, and the reformats (MPRs/MIPs) the radiographer is expected to reconstruct and push — before the patient leaves.

Core PACS terminology

PACS: Picture Archiving & Communication System — stores, retrieves, distributes and displays medical images. Talks to modalities and the RIS/EHR via DICOM and HL7.
Primary archive: The authoritative, long-term store of record — the “source of truth” the site is medico-legally required to retain for the full retention period. High-integrity, backed up, usually on-site or primary cloud.
Secondary archive: A second independent copy for redundancy / disaster recovery / business continuity — geographically or logically separate from primary, so loss of one site doesn’t lose the study. May be lower-cost/slower (“nearline”) storage.
VNA: Vendor-Neutral Archive — a storage layer independent of any single PACS vendor, holding images in standard DICOM so multiple PACS/EHR viewers can access one shared copy. Often serves as the primary archive across departments.
On / near / off-line: Tiered storage by access speed: on-line = instant (recent studies, fast disk); near-line = seconds–minutes (older studies, slower/cheaper media); off-line = manual retrieval (archive/tape).
DICOM node / AE title: A network destination on the DICOM network. Each device has an Application Entity (AE) title, IP and port — you “send to” a node by its AE title.
C-STORE / query-retrieve: DICOM services: C-STORE pushes images to a node; C-FIND / C-MOVE (query-retrieve) pulls studies from an archive.
Worklist (MWL): Modality Worklist — the scanner pulls booked patient/exam demographics from the RIS so IDs and accession numbers match automatically (avoids typos & mismatched studies).
Accession number: Unique per-exam identifier from the RIS that ties images ↔ order ↔ report. Wrong accession = study lands on the wrong order.
Series vs study: A study is the whole exam for one accession; a series is one acquisition/sequence within it.
Presentation state (GSPS): Saved annotations, measurements, window/level and reformat orientation stored alongside images so the reader sees what you set up.
Key images / KOS: Key Object Selection — flagged representative images (e.g. the measured lesion) so the reader/clinician finds the finding fast.
Thin vs thick: Thin-slice source data feeds reformats & 3D; thick/averaged series are for quick reading. Archive both when the protocol needs post-processing later.

Send discipline (every exam): verify patient ID & accession from the worklist before pushing · send all acquired series plus required reformats · confirm the study “verified/complete” on PACS before the patient leaves · check both primary and secondary archive received it if your site doesn’t auto-mirror · save presentation state/key images for measured findings.

What to send & which reformats to build — by body part

Body part	Series to send	Reformats / reconstructions to make & send
Brain (routine)	All acquired: T1, T2, FLAIR, DWI + ADC map, T2* / SWI, post-Gd T1 (if given).	SWI minIP (thick) for microbleeds/veins; 3D T1 post-Gd → ax/cor/sag MPR; ensure ADC map is generated & sent (not just DWI).
Brain — epilepsy/tumour (3D)	3D FLAIR, 3D T1 (pre/post), DWI+ADC.	Thin-slice 3D → orthogonal MPRs; hippocampal oblique-coronal reformats perpendicular to long axis of hippocampus.
MRA — intracranial / carotid TOF	Source axial images + acquired.	MIP: full-volume + targeted/rotational MIPs (per-vessel), plus keep source images (MIP can hide small aneurysms).
Pituitary / IAM	Thin coronal & sagittal T1/T2 ± dynamic post-Gd.	Small-FOV MPRs if 3D acquired; send dynamic phases in order.
Cervical / lumbar spine	Sag T1, Sag T2 (± STIR), Axial T2 (± T1) through relevant levels.	Axial obliques angled to each disc space for stenosis; if 3D, cor/sag reformats. Confirm level labelling.
MRCP	Thin-slab 3D + thick-slab radial HASTE, axial/coronal T2.	Rotational MIP / radial reprojections of the biliary tree from the 3D volume; send the radial set.
Liver / abdomen (dynamic)	In/out-phase, T2, DWI+ADC, dynamic post-Gd (pre, arterial, portal, delayed / hepatobiliary).	Subtraction (post − pre) for enhancement; label dynamic phases; ADC map; coronal reformat if 3D.
Prostate (mpMRI)	T2 (ax/cor/sag), DWI high-b + ADC, DCE dynamic.	Calculated high-b (e.g. b1400) if not acquired; ADC map; ensure DCE series ordered/labelled; PI-RADS key images.
Pelvis — gynae / rectal	T2 (ax/sag/cor), oblique T2 to organ axis, DWI+ADC, ± post-Gd.	Oblique reformats/acquisitions perpendicular & parallel to organ axis (short-axis to cervix/rectal wall); ADC map.
Cardiac MR	Cines (SA stack, 2/3/4-ch), T1/T2 mapping, LGE, perfusion.	Reformat short-axis stack from long-axis planning; map images (native/post-contrast T1, ECV if computed); send mapping colour overlays + source.
MSK — knee/shoulder/ankle	All planes PD/T2 fat-sat + T1; cartilage/effusion sequences.	If 3D isotropic → orthogonal & oblique MPRs (along ligament/labrum); radial reformats for hip labrum/shoulder.
MSK — 3D isotropic / tumour	Isotropic source + standard planes.	Orthogonal MPRs; long-axis + short-axis to the lesion/bone; whole-lesion measurement key images.
Peripheral / contrast MRA run-off	Source stations, mask & post-contrast.	Subtracted MIPs per station + composed whole-leg MIP; keep source for stenosis grading.

Reformat rule of thumb: always archive the thin-slice source whenever you send a MIP/minIP/MPR — projections can obscure small lesions, and the reader (or a later re-read) may need to re-reconstruct. Label every reformat clearly (plane + technique) so it is unambiguous in the study.

Retention periods, archive architecture (VNA/primary/secondary) and required reformats vary by jurisdiction and department — follow your local imaging IT and reporting-radiologist standards. Educational content only.

MRI Protocol Recommendations & Scan Parameters (2025–2026)

Overview

Neuro & spine

Musculoskeletal

Body & oncology

Cardiac & vascular

MRI Patient Positioning — Quick Reference

Brain (routine)

Brain — epilepsy / hippocampal

IAMs / CP angle

Pituitary / sella

Orbits

MRA — Circle of Willis

Carotid MRA (neck)

Cervical spine

Thoracic spine

Lumbar spine

Whole spine

Shoulder

Elbow

Wrist

Hand / fingers

Hip (single)

Pelvis / SIJ

Knee

Ankle

Foot

TMJ

Liver / MRCP

Pancreas

Adrenals

Kidneys / MR urography

Small bowel — MR enterography

Rectum

Prostate

Female pelvis

Breast

Cardiac — function / viability

Aorta MRA

Peripheral run-off MRA

Neck (soft tissue)

Brachial plexus

Fetal MRI

Phase-encode direction & saturation bands

Neuro

Spine

Body & pelvis

Cardiac & vascular

MSK

Saturation bands — types & placement

PACS: definitions, what to send & reformats

Core PACS terminology

What to send & which reformats to build — by body part