RadteraMRI Brain With and Without Contrast
MR+ ContrastNeuro
Indications
- Known/suspected brain tumor or metastases
- Infection (abscess, meningitis, encephalitis)
- Postoperative tumor follow-up
- Suspected MS (active demyelination)
- Cranial neuropathy
- Pituitary/parasellar lesion (dedicated protocol preferred)
Patient prep
- MRI safety screening
- IV access for gadolinium
- Renal function (eGFR) per site policy for GBCA
- Head coil
Contrast
Agentgadolinium-based (e.g., gadobutrol, gadoterate)
RouteIV
Dose0.1 mmol/kg
TimingPost-contrast T1 in 3 planes (or 3D) after injection
Technique
- Same positioning as non-contrast brain
- Acquire full non-contrast set first (incl. DWI, FLAIR, SWI)
- Post-contrast T1 axial + coronal, or 3D T1 (MPRAGE/BRAVO/TFE) for thin reconstructions
- 3D post-contrast T1 preferred for metastasis detection
Series / Sequences
| # | Series / Sequence | Plane | Weighting / Recon | Thickness | Notes |
|---|---|---|---|---|---|
| 1 | Sag T1 | sagittal | T1 | 4-5 mm | Pre-contrast |
| 2 | Ax DWI/ADC | axial | DWI | 4-5 mm | |
| 3 | Ax T2 FSE | axial | T2 | 4-5 mm | |
| 4 | Ax FLAIR | axial | FLAIR | 4-5 mm | |
| 5 | Ax SWI/GRE | axial | T2* | 3-4 mm | |
| 6 | Ax T1 pre | axial | T1 | 4-5 mm | Baseline for enhancement |
| 7 | Ax T1 post | axial | T1 +C | 4-5 mm | Post-gadolinium |
| 8 | Cor T1 post | coronal | T1 +C | 4-5 mm | |
| 9 | 3D T1 post (MPRAGE) | sagittal/axial | T1 +C | 1 mm | Isotropic; reformat any plane; best for mets |
Key points
- Pre-contrast T1 needed to distinguish enhancement from intrinsic T1 shortening (blood/melanin/fat).
- For metastasis screening, isotropic 3D post-contrast T1 increases small-lesion detection.
- Add post-contrast FLAIR for leptomeningeal disease.
- MS: include before/after to demonstrate active (enhancing) lesions.
References
• ACR-ASNR-SPR Practice Parameter for MRI of the Brain
• Radiopaedia: MRI brain with contrast
• ACR Appropriateness Criteria: Cerebral metastases
• Radiopaedia: MRI brain with contrast
• ACR Appropriateness Criteria: Cerebral metastases
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.