I use the knee coil but have the patient lay on their side so that their arm remains supinated. The key is to use lots of sponges, cushions, pillows and sandbags so that the patient is as comfortable as possible! Using fast imaging sequences also makes a big difference 👍
I like to position most of my patients in the left or right lateral sideline, like the 2nd pt position. Flex coil over extended arm and sandbag. Best way to get isocenter on most patients. Thick pads down the length of the table, to lay on. Thin pillow under axilla for side down, thin pillow under head and above the extended arm with headphones backwards to avoid cord draping down into the patients face. Pillow between knees and a pillow behind the shoulder and back and the sidewall of the magnet for support while in sideling position. I always let the pt know how far into the magnet bore they are so they don't fall backwards off the table. Works for most.. older Espree 1.5T wide bore. Downside is sore shoulder at the end.
Great video! I like the most comfortable position( the 2nd one) because its better for those that image kids. My question is: when using this particular position, how do you enter patients position in the system so that images will appear in the anatomical position when viewed?
Thanks and good question. At our workplace rads wants head first supine. But mostly I think it’s important to have a common understanding within the workplace. So everyone does the same. However, marking the side of the elbow is crucial. What about your workplace?
Also, take into account that many patients with elbow problems may also have shoulder problems, and are unable to fully lift their arms above their heads, which makes the supine position the most robust position IMO. On a related note, did you swap phase for the supine position (from L/R to H/F) for the Coronal views or (L/R to A/P) for the axials?
Nice explanation!!! I would only do in super man position since i only had the knee coil and the bore of the magnet is smaller, elbow is one of the region am not looking forward to scan on closed magnet MRI
Good question. Ai is artificial intelligence. Many vendors have this available now. I used siemens which is called deep resolve boost. Ai based approach. Here is a video th-cam.com/video/vEB1thIue5w/w-d-xo.html
I think I would choose superman with the flex or knee coil. Just being able to speed even up without thinking about fold over. But not all patient can lie like that unfortunately.
I would like to do some videos for the Older systems... b17 and b19 software.. lots of them still out there and lots of people need tutorials!! My Question is how do you video this? I would think setting up a camera in front of the screen interferes with actually using the keyboard, and seeing what you are doing.
Anders ser ikke ut til å trivest så veldig godt i knespolen 😅. Prøver alltid å få pasienten i sideleie med armen opp dersom det er mulig. Jeg har aldri benyttet knespole men tenker jeg burde på pasienter som er fleksible nok. Vi har dessverre kun 4 kanals flex på vår aldrende Aera.
Remember that the elbow and palm do not have to face up. As long as the elbow and wrist are in the same plane, ie not pronated scans will work perfectly. The key is patient comfort. I go for prone with the hand and elbow at 90 degrees, like a lateral elbow X ray position. Good localisers and off you go. Supine for those patients with immobility issues. These tend to have breathing artifacts at times though. Does anyone have a way around this??
Awesome 👍👍👍
I use the knee coil but have the patient lay on their side so that their arm remains supinated. The key is to use lots of sponges, cushions, pillows and sandbags so that the patient is as comfortable as possible! Using fast imaging sequences also makes a big difference 👍
Much agreed 👍
Dude! Thanks for posting this on Reddit. I didn't know you had a channel. Subbing now.....
I like to position most of my patients in the left or right lateral sideline, like the 2nd pt position. Flex coil over extended arm and sandbag. Best way to get isocenter on most patients. Thick pads down the length of the table, to lay on. Thin pillow under axilla for side down, thin pillow under head and above the extended arm with headphones backwards to avoid cord draping down into the patients face. Pillow between knees and a pillow behind the shoulder and back and the sidewall of the magnet for support while in sideling position. I always let the pt know how far into the magnet bore they are so they don't fall backwards off the table. Works for most.. older Espree 1.5T wide bore. Downside is sore shoulder at the end.
Thanks for sharing your tips and tricks. ☺️
Excellent explanation 👌
I use body coil. Patient laying on his/her's back, arm in supine position, and body coil on top of the arm. Images are great.
Nice
Great video! I like the most comfortable position( the 2nd one) because its better for those that image kids. My question is: when using this particular position, how do you enter patients position in the system so that images will appear in the anatomical position when viewed?
Thanks and good question. At our workplace rads wants head first supine. But mostly I think it’s important to have a common understanding within the workplace. So everyone does the same. However, marking the side of the elbow is crucial. What about your workplace?
you are a legend, thanks man for this really useful videos !
Thanks for kindly words. Much appreciated. ☺️
Happy New Year Bac !!🎉🎉🎊🎊🎊🎊
Happy New Year ☺️
Thanks for the tips! I dislike elbows mostly because I wind up with large patients that struggle with any position and trying to keep them isocenter.
True situation and it’s difficult then.
Make video on Perfusion in detail
Thank you!!! Happy New Year!!!
Happy New Year.
Also, take into account that many patients with elbow problems may also have shoulder problems, and are unable to fully lift their arms above their heads, which makes the supine position the most robust position IMO. On a related note, did you swap phase for the supine position (from L/R to H/F) for the Coronal views or (L/R to A/P) for the axials?
Supine: for coronal HF. transversal LR
Hi! Can we please have some tips for the 3D colangiography in free breathing? Maybe in a 3T scanner
You seen this? th-cam.com/video/Ohxxt9diw-s/w-d-xo.html
Same principle on 3T as well.
I dont have elbow coil and flex coil, so we do some uncomfort position for patient with genu or anterior coil if patient in supine position. 😢
Nice explanation!!!
I would only do in super man position since i only had the knee coil and the bore of the magnet is smaller, elbow is one of the region am not looking forward to scan on closed magnet MRI
Hi Bac, again asweome video, what is "ia" how can you activated ? thanks again
Good question. Ai is artificial intelligence. Many vendors have this available now. I used siemens which is called deep resolve boost. Ai based approach. Here is a video th-cam.com/video/vEB1thIue5w/w-d-xo.html
@@Nguyen_MRI Bac you are the man. Thanks I appreciate your afford and help. 👍
How do you do elbow imaging at your site? ☺️
I always check/adjust the shim for FS seq. Depending on the homogenity of the fat suppression i might supplement the exam with a STIR seq.
@@Gun1ld smart move 👍
Excellent video, what patient position do you choose in the mri for the three options?
I think I would choose superman with the flex or knee coil. Just being able to speed even up without thinking about fold over. But not all patient can lie like that unfortunately.
@@Nguyen_MRI in the mri you choose lateral prone o prone only?
@@franciscomorales15 good question. patient is laying somewhere between lateral and not lateral. But prone for sure. I choose prone. You?
@@Nguyen_MRI i think prone, thanks 👏
WHAT POSITION WOULD YOU REGISTER THE PATIENT IF DOING SUPERMAN POSITION WITH ARM EXTENDED IN FRONT. HEAD FIRST SUPINE ?
I would like to do some videos for the Older systems... b17 and b19 software.. lots of them still out there and lots of people need tutorials!! My Question is how do you video this? I would think setting up a camera in front of the screen interferes with actually using the keyboard, and seeing what you are doing.
You can you camtasia for recording. Then export the file to an usb pen.
knee coil is optimum ,I do it. Just need a well prepared fast protocol
T2 without fat sat… old skool sequences. Also, generally want a FABS view around the elbow if the distal biceps is to be accurately assessed.
Thanks for input.
Anders ser ikke ut til å trivest så veldig godt i knespolen 😅. Prøver alltid å få pasienten i sideleie med armen opp dersom det er mulig. Jeg har aldri benyttet knespole men tenker jeg burde på pasienter som er fleksible nok. Vi har dessverre kun 4 kanals flex på vår aldrende Aera.
Heheh den er litt vondt ja. Men ofte best og lettest. Ikke passet til alle slik nei. Håper dere får oppgradert til en fit snart. Ville vært konge.
do you know speak vietnamese
Yes
Nice . Viet Nam (y)
Remember that the elbow and palm do not have to face up. As long as the elbow and wrist are in the same plane, ie not pronated scans will work perfectly.
The key is patient comfort. I go for prone with the hand and elbow at 90 degrees, like a lateral elbow X ray position. Good localisers and off you go. Supine for those patients with immobility issues. These tend to have breathing artifacts at times though. Does anyone have a way around this??
👍🏻
But the hand should be supinated for a true position
It’s not supinated?