Revision History


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.

  • Failure to meet anatomic coverage and imaging plane specifications may result in a fail of the submitted examination.

Female Pelvis such as for Uterine or Adnexal Disease

This examination is a high-resolution female pelvis protocol. Single shot techniques (HASTE, SSFSE, SSTSE and steady state free precession such as FIESTA, TRUE FISP, BFFE) are not acceptable substitutions for the female pelvis high resolution sequence. 

The exam must include a uterus.

Required Sequences

Category A: 

Pulse Sequence and Image Contrast

Category B: 

Anatomic Coverage and Imaging Planes

Category C: 

Spatial Resolution

Sagittal high resolution bright fluid

  • The uterine corpus zonal anatomy must be clearly defined

  • The uterine cervix zonal anatomy must be clearly defined


  • Must cover the uterus, cervix, adnexa and pelvic sidewalls


  • Slice thickness ≤ 5.0 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 1.0 mm2

Axial or oblique axial high resolution bright fluid

  • The uterine corpus zonal anatomy must be clearly defined

  • The uterine cervix zonal anatomy must be clearly defined

  • Must cover from iliac crests to vaginal introitus

  • Must cover pelvic sidewalls

  • Slice thickness ≤ 5.0 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 1.0 mm2

Axial whole pelvis dark fluid

  • Fat must be hyperintense

  • Must cover entire bony pelvis

  • Slice thickness ≤ 5.0 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 2.4 mm2

Sagittal or axial dark fluid with fat suppression

  • Fat must be hypointense

  • All scan parameters must be identical to the post contrast

  • Sagittal must cover the uterus, cervix, adnexa and pelvic sidewalls

  • Axial must cover entire bony pelvis

If sagittal:
  • Slice thickness ≤ 4.0 mm

  • Gap ≤ 0.0 mm

  • Pixel area ≤ 2.4 mm2

If axial:
  • Slice thickness ≤ 5.0 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 2.4 mm2

Sagittal or axial dark fluid with fat suppression post contrast

  • Fat must be hypointense

  • All scan parameters must be identical to the pre-contrast

  • Must show sufficient uterine enhancement

  • Sagittal must cover the uterus, cervix, adnexa and pelvic sidewalls

  • Axial must cover entire bony pelvis

If sagittal:
  • Slice thickness ≤ 4.0 mm

  • Gap ≤ 0.0 mm

  • Pixel area ≤ 2.4 mm2

If axial:
  • Slice thickness ≤ 5.0 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 2.4 mm2



Pediatric Pelvis such as for Tumor Diagnosis or Follow-Up

Required Sequences

Category A: 

Pulse Sequence and Image Contrast

Category B: 

Anatomic Coverage and Imaging Planes

Category C: 

Spatial Resolution

Sagittal high resolution bright fluid

  • The bladder, rectum and adjacent reproductive organs (if reproductive organs present) should be clearly defined

  • Must include soft tissues of the pelvis and bone marrow of the spine

  • Must cover the pelvic sidewalls

  • Slice thickness ≤ 5.0 mm

  • Gap ≤ 1.5 mm 

  • Pixel area ≤ 1.0 mm2

Axial high resolution bright fluid

  • Must have good discrimination of bladder from rectum and adjacent reproductive organs (if reproductive organs present)

  • Must have good definition of the surrounding soft tissues and bone marrow


  • Must cover entire bony pelvis and surrounding soft tissues and musculature and extend through perineum

  • Slice thickness ≤ 5.0 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 1.0 mm2

Axial whole pelvis dark fluid

  • Fat must be hyperintense

  • Must cover entire bony pelvis and surrounding soft tissues and musculature and extend through perineum

  • Slice thickness ≤ 5.0 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 2.4 mm2

Sagittal or axial dark fluid with fat suppression

  • Fat must be hypointense

  • All scan parameters must be identical to the post contrast

  • Sagittal must cover the pelvic sidewalls

  • Must cover entire bony pelvis and surrounding soft tissues and musculature and extend through perineum

If sagittal:

  • Slice thickness ≤ 4 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 2.4 mm2

If axial:

  • Slice thickness ≤ 5 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 2.4 mm2
Sagittal or axial dark fluid with fat suppression post contrast
  • Fat must be hypointense

  • All scan parameters must be identical to the pre-contrast

  • Sagittal must cover the pelvic sidewalls

  • Must cover entire bony pelvis and surrounding soft tissues and musculature and extend through perineum

If sagittal:

  • Slice thickness ≤ 4 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 2.4 mm2

If axial:

  • Slice thickness ≤ 5 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 2.4 mm2



Hepatobiliary to Include MRCP

Required Sequences

Category A: 

Pulse Sequence and Image Contrast

Category B: 

Anatomic Coverage and Imaging Planes

Category C: 

Spatial Resolution

In phase/out of phase dark fluid 

  • Must have adequate hepatic/ splenic contrast

  • Must display appropriate signal loss on opposed-phase images

  • Must have good definition of surrounding soft tissues

  • Must be obtained prior to contrast administration


  • Must cover the entire liver




  • Slice thickness ≤ 7.0 mm

  • Gap ≤ 1.5 mm 

  • Pixel area ≤ 7.2 mm2

Axial or coronal long TR bright fluid with or without fat suppression

  • Must have good discrimination of liver from biliary tree

  • Must have good definition of surrounding soft tissues

  • Steady State Free Precession sequences, such as FIESTA and true FISP are not adequate substitutions for TSE, FSE or IR sequences at this time and are not acceptable for this sequence

  • Must cover the entire liver



  • Slice thickness ≤ 7.0 mm

  • Gap ≤ 1.5 mm 

  • Pixel area ≤ 3.75 mm2

MRCP 3D or 2D

  • You may submit a 3D or 2D sequence for MRCP

  • One reformatted MIP image is required for 3D gated MRCP

  • Must have good fluid discrimination

  • Must cover the central biliary tree including the second order branches

  • Must cover the entire pancreas

  • Bile ducts and pancreatic ducts must be well defined

3D:

  • Slice thickness ≤ 2.0 mm

  • Voxel volume ≤ 5.2 mm3

2D Thick Slab:

  • Slice thickness > 40 mm, < 60 mm

  • Gap 0.0 mm

  • Pixel area ≤ 1.0 mm2

Axial 3D dark fluid dynamic with fat suppression post contrast

(The testing package will calculate spatial resolution as voxel volume, but your images must meet the pixel area requirements listed)

  • Must have good definition of surrounding soft tissues

  • Must have at least four phases:

    • Pre-contrast

    • Parenchymal arterial

    • Portal venous

    • Equilibrium or delayed

  • Must cover the entire liver

  • Slice thickness ≤ 6.0 mm

  • Gap = 0 mm

  • Pixel area ≤ 4.5 mm2



Pediatric Abdomen with Dynamic Liver Assessment

Required Sequences

Category A: 

Pulse Sequence and Image Contrast

Category B: 

Anatomic Coverage and Imaging Planes

Category C: 

Spatial Resolution

In phase/out of phase dark fluid

  • Must have adequate hepatic/ splenic contrast

  • Must display appropriate signal loss on opposed-phase images

  • Must have good definition of surrounding soft tissues

  • Must cover the entire liver

  • Slice thickness ≤ 5.0 mm

  • Gap ≤ 1.5 mm 

  • Pixel area ≤ 7.2 mm2

Axial or coronal long TR bright fluid with or without fat suppression

  • Must have good discrimination of liver from biliary tree

  • Must have good definition of surrounding soft tissues

  • Must cover the entire liver

  • Slice thickness ≤ 5.0 mm

  • Gap = 1.5 mm

  • Pixel area ≤ 3.75 mm2

Axial 3D dark fluid dynamic with fat suppression post contrast

  • Must have good definition of surrounding soft tissues

  • Must have at least four phases:

    • Pre-contrast

    • Parenchymal arterial

    • Portal venous

    • Equilibrium or delayed

**Either extracellular gadolinium-based contrast agents (GBCA) or combined extracellular-hepatobiliary GBCA (Gadoxetate disodium-EOVIST ™) are acceptable

  • Must cover the entire liver

  • Slice thickness ≤ 5.0 mm

  • Gap = 0 mm

  • Pixel area ≤ 4.5 mm2



Renal

Required Sequences

Category A: 

Pulse Sequence and Image Contrast

Category B: 

Anatomic Coverage and Imaging Planes

Category C: 

Spatial Resolution

Axial or coronal bright fluid with fat suppression

  • Must have good discrimination between the kidney and the collecting system

  • Steady State Free Precession sequences, such as FIESTA and true FISK are not adequate substitutions for TSE, FSE or IR sequences at this time, and are not acceptable for this sequence

  • Axial must cover both adrenal glands and kidneys entirely

  • Coronal must cover both kidneys anterior to posterior

  • Slice thickness ≤ 7.0 mm

  • Gap ≤ 1.5 mm 

  • Pixel area ≤ 3.75 mm2

Axial in-phase/

opposed phase dark fluid
  • Must have good corticomedullary discrimination

  • Must have good definition of surrounding tissues

  • Must cover both adrenal glands and kidneys entirely

  • Slice thickness ≤ 7.0 mm

  • Gap ≤ 1.5 mm 

  • Pixel area ≤ 7.2 mm2

Dynamic axial or coronal dark fluid with fat suppression post contrast

  • Must have sufficient IV contrast enhancement of the renal parenchyma over time

  • Must include a pre-contrast phase

  • Axial must cover both adrenal glands and kidneys entirely

  • Coronal must cover both kidneys anterior to posterior

  • Slice thickness ≤ 5.0 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 2.4 mm2





Revision History for this Article

Date

Section

Description of Revision(s)

12-12-19

All

Article created; FAQs incorporated; No criteria changes

12-16-19Hepatobiliary to include MRCPAxial or coronal long TR bright fluid with or without fat suppression: Corrected slice thickness from </= 1.0 mm to </= 7.0 mm.
12-16-19Body Module General Instructions

Removed the following bullet: 

  • Single shot techniques (HASTE, SSFSE, SSTSE and steady state free precession such as FIESTA, TRUE FISP, BFFE) are not acceptable subsitutions in ANY of the body module exams
12-19-19Hepatobiliary to include MRCPIn phase/out of phase dark fluid: Corrected pixel area to ≤ 7.2 mm2
1-21-2020Hepatobiliary to include MRCP
Axial or coronal long TR bright fluid with or without fat suppression in category A: Pulse Sequence and Image Contrast please added the bullet:  Steady State Free Precession sequences, such as FIESTA and true FISP are not adequate substitutions for TSE, FSE or IR sequences at this time, and are not acceptable for this sequence.
1-21-2020RenalAxial or coronal long TR bright fluid with   fat suppression in category A: Pulse Sequence and Image Contrast please add the bullet:  Steady State Free Precession sequences, such as FIESTA and true FISP are not adequate substitutions for TSE, FSE or IR sequences at this time, and are not acceptable for this sequence.



Previous: Exam-Specific Parameters: MSKNext: Exam-Specific Parameters: MRA