Safe Setup and Three‑Plane Planning for Brain MRI After safety checks, position the patient head‑first supine in the head coil, provide an emergency buzzer and headphones, center to the glabella, and move them into the scanner comfortably. In the control room, enter accurate patient details including weight, register head‑first supine, select the protocol per hospital and radiologist guidelines, and run a three‑plane localizer. Plan axial imaging in all three planes: on the sagittal localizer, align slices parallel to the line joining the inferior borders of the genu and splenium of the corpus callosum and cover from vertex to below the foramen magnum; on the coronal localizer, set the central slice along a line from the superior sagittal sinus through the third ventricle to the brainstem; center the axial localizer in the field of view and copy this planning to subsequent axial T2, T1, and other sequences. Plan coronal imaging perpendicular to the genu–splenium line on the sagittal localizer, covering frontal sinus to occipital lobe; center the image in the coronal field of view, and on the axial view keep slices perpendicular to the midline with the center line over it. For sagittal imaging, adjust in the sagittal field of view with the central slice parallel to the midline and cover side to side; for diffusion, align axial slices from the glabella to the foramen magnum to reduce sinus–skull base artifact, cover vertex to foramen magnum, and center to the midline in coronal and axial views.
Contrast Workflow and Core Sequence Interpretation Before gadolinium, confirm kidney function per guidelines and proceed only if safe; when planning post‑contrast sequences, copy axial planning from the pre‑contrast T1 and coronal post‑contrast from the pre‑contrast T1 coronal, enter the correct contrast name and volume, and remind the patient to lie still. Inject contrast following hospital and manufacturer guidelines, check for extravasation and patient well‑being, then continue with post‑contrast sequences. Review images as the scan proceeds: on T2, fluids and fat are bright and most pathologies are bright; on FLAIR, fluid is dark while fat and most pathologies remain bright, useful near ventricles and sulci. On T1, fluid is dark, fat is bright, and most pathologies are dark; in diffusion, b0 resembles T2, higher b‑values such as b500 and b1000 show restricted diffusion as bright, while ADC maps show restricted diffusion as dark. Post‑contrast T1 reveals enhancing lesions as bright compared with non‑contrast in both axial and coronal views.