MRI Exam-Specific Parameters: Head and Neck Module (Revised 4-6-2022)
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Modified on: Wed, 6 Apr, 2022 at 1:26 PM
In addition to the exam-specific instructions in the following tables, review the following information prior to examination selection and submission. Failure to follow the guidance below may result in failure of the submitted examination.
ADC map is now required for brain for TIA DWI sequence. Omission of the ADC map will result in failure of the submitted examination.
Failure to meet anatomic coverage and imaging plane specifications may result in failure.
Brain for Suspected Demyelinating Disease, Encephalitis or Acute Disseminated Encephalomyelitis |
Required Sequences | Category A: Pulse Sequence and Image Contrast | Category B: Anatomic Coverage and Imaging Planes | Category C: Spatial Resolution |
Axial, sagittal or coronal dark fluid | Must have good discrimination between the brain and CSF
| Axial must cover convexity to foramen magnumCoronal must cover entire brain from anterior to posterior cranial vaultSagittal must cover entire brain from left to right and the top of the brain to the C2 level
| Slice thickness ≤ 5.0 mmGap ≤ 2.5 mm if coronalGap ≤ 2.0 mm if axial or sagittalPixel area ≤ 1.2 mm2
|
Sagittal T2 FLAIR | Must have good water suppressionCSF must be hypointense relative to white matter
| Sagittal must cover entire brain from left to right and the top of the brain to the C2 level
| Slice thickness ≤ 5.0 mmGap ≤ 2.0 mmPixel area ≤ 2.0 mm2
|
Axial T2 FLAIR | Must have good water suppressionCSF must be hypointense relative to white matterReformatted axial T2 FLAIR images from the 3D sagittal T2 FLAIR are acceptableDIR FLAIR is an acceptable substitute for T2 FLAIR
| Axial must cover from convexity to foramen magnum
| Slice thickness ≤ 5.0 mmGap ≤ 2.0 mmPixel area ≤ 1.2 mm2
|
Axial Bright Fluid | CSF must be hyperintense relative to the brainMust have good contrast between the gray matter and white matterShould be a Fast Spin Echo (Turbo Spine Echo, RARE) NOT a gradient echo
| Axial must cover from convexity to foramen magnum
| Slice thickness ≤ 5.0 mmGap ≤ 2.0 mmPixel area ≤ 1.2 mm2
|
Axial, sagittal or coronal dark fluid post contrast | Must have good discrimination between the brain and CSF
| Axial must cover convexity to foramen magnumCoronal must cover entire brain from anterior to posterior cranial vault
| Slice thickness ≤ 5.0 mmGap ≤ 2.0 mmPixel area ≤ 1.2 mm2
|
IAC/Temporal Bones |
Required Sequences | Category A: Pulse Sequence and Image Contrast | Category B: Anatomic Coverage and Imaging Planes | Category C: Spatial Resolution |
Axial or coronal high resolution dark fluid without fat suppression | Must have good discrimination of the 7th and 8th cranial nerves
| Must cover top of IACs to cervical-medullary junction
| Slice thickness ≤ 3.0 mmGap ≤ 0.2 mm Pixel area ≤ 0.6 mm2
|
Axial or coronal high resolution bright fluid | Must have good discrimination of the 7th and 8th cranial nervesMust have good membranous labyrinth discrimination
| Must cover top of IACs to foramen magnum- Coronal must cover pituitary to 4th ventricle
| Slice thickness ≤ 2.0 mmGap = 0 mm (zero gap)Pixel area ≤ 0.6 mm2
|
Axial high resolution dark fluid with or without fat suppression post contrast | Must have good discrimination of the 7th and 8th cranial nerves
| Must cover top of IACs to foramen magnum
| Slice thickness ≤ 3.0 mmGap ≤ 0.2 mmPixel area ≤ 0.6 mm2
|
Coronal high resolution dark fluid with or without fat suppression post contrast | Must have good discrimination of the 7th and 8th cranial nerves
| Must cover top of IACs to foramen magnum
| Slice thickness ≤ 3.0 mmGap ≤ 0.2 mmPixel area ≤ 0.6 mm2
|
Brain for TIA or StrokeOmission of the ADC map will result in failure of the submitted examination |
Required Sequences | Category A: Pulse Sequence and Image Contrast | Category B: Anatomic Coverage and Imaging Planes | Category C: Spatial Resolution |
Sagittal, axial or coronal dark fluid | Must have good discrimination between the brain and CSF
| | Slice thickness ≤ 5.0 mmGap ≤ 2.5 mm if coronalGap ≤ 2.0 mm if axial or sagittalPixel area ≤ 1.2 mm2
|
Axial diffusion weighted imaging (DWI) including ADC map | Must include ADC map and B value must be ≥ 800
| Axial must cover the entire brain
| Slice thickness ≤ 5.0 mmGap ≤ 2 mm Pixel area ≤ 4 mm2
|
Axial or coronal T2 FLAIR | | Axial must cover the entire brainCoronal must cover entire brain from anterior to posterior cranial vault
| Slice thickness ≤ 5.0 mmGap ≤ 2 mmPixel area ≤ 1.2 mm2
|
Axial bright fluid | | Axial must cover the entire brain
| Slice thickness ≤ 5.0 mmGap ≤ 2 mmPixel area ≤ 1.2 mm2
|
Axial or coronal T2* weighted gradient echo | CSF must be hyperintense relative to the brainSusceptibility weighted imaging or SWAN sequence is an acceptable substitute, if submitted the CSF need not be hyperintense relative to the brain
| Axial must cover the entire brainCoronal must cover entire brain from anterior to posterior cranial vault
| Slice thickness ≤ 5 mmGap ≤ 2.5 mmPixel area ≤ 1.2 mm2
|
Orbits for Vision Loss or Tumor |
Required Sequences | Category A: Pulse Sequence and Image Contrast | Category B: Anatomic Coverage and Imaging Planes | Category C: Spatial Resolution |
Axial dark fluid | Must have good optic nerve sheath discriminationFat must be bright
| Must cover entire orbits and optic nerves
| Slice thickness ≤ 3.0 mmGap ≤ 1.0 mm Pixel area ≤ 1.0 mm2
|
Coronal bright fluid with fat suppression which includes STIR or frequency-selective fat suppression techniques | | Must cover eyelids to dorsum sella
| Slice thickness ≤ 5.0 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Axial dark fluid with fat suppression post contrast | Must have good optic nerve sheath discriminationMust have good fat suppression
| Must cover entire orbits and optic nerves
| Slice thickness ≤ 3.0 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Coronal dark fluid with fat suppression post contrast | Must have good optic nerve sheath discriminationMust have good fat suppression
| Must cover eyelids to dorsum sella
| Slice thickness ≤ 5.0 mmGap ≤ 1.0 mmPixel area ≤ 1.0 mm2
|
Pituitary with Contrast Enhancement |
Required Sequences | Category A: Pulse Sequence and Image Contrast | Category B: Anatomic Coverage and Imaging Planes | Category C: Spatial Resolution |
Sagittal dark fluid | Must have good discrimination between brain and CSF
| Must cover from medial temporal lobe to medial temporal lobe
| Slice thickness ≤ 3.3 mmGap ≤ 0.3 mm Pixel area ≤ 0.6 mm2
|
Coronal dark fluid | Must have good discrimination between brain and CSF
| Must cover from orbital apex to dorsum sella
| Slice thickness ≤ 3.3 mmGap ≤ 0.3 mm Pixel area ≤ 0.6 mm2
|
Sagittal dark fluid post contrast | Must have good discrimination between brain and CSF
| Must cover from medial temporal lobe to medial temporal lobe
| Slice thickness ≤ 3.3 mmGap ≤ 0.3 mmPixel area ≤ 0.6 mm2
|
Coronal dark fluid post contrast | Must have good discrimination between brain and CSF
| Must cover from orbital apex to dorsum sella
| Slice thickness ≤ 3.3 mmGap ≤ 0.3 mmPixel area ≤ 0.6 mm2
|
Revision History for this Article |
Date | Section | Description of Revision(s) |
12-12-19 | All | Article created; FAQs incorporated; No criteria changes |
12-16-19 | Brain for TIA or Stroke | Sagittal, axial or coronal dark fluid: Correct the Gap from </= 2.5 mm if axial or sagittal to </= 2.0 mm if axial or sagittal.
|
12-17-19 | Brain for TIA or Stroke | Axial diffusion weighted imaging (DWI) including ADC map: Changed B value must be ≤ 800 to ≥800
|
1-8-2020 | Brain for TIA or Stroke | Axial diffusion weighted imaging (DWI) including ADC map: Changed gap to ≤ 2 mm |
1-8-2020 | Orbits for Vision Loss or Tumor | Coronal bright fluid with fat suppression which includes STIR or frequency-selective fat suppression techniques: Change gap to ≤ 1.0 mm. |
1-17-2020 | Brain for Suspected Demyelinating Disease, Encephalitis, or Acute Disseminate Encephalomyelitis | Sagittal T2 Flair- Changed pixel area to ≤ 2.0 mm2
|
4-9-2020 | IAC/Temporal Bones | Axial or coronal high resolution dark fluid without fat suppression: Corrected gap from ≤ 2.0 mm to ≤ 0.2 mm.
|
4-6-2022 | Brain for Suspected Demyelinating Disease, Encephalitis, or Acute Disseminate Encephalomyelitis
| Required Sequences: Added sagital to the post contrast sequence
|
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