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 failure.



MRA Abdomen for Renal Artery Stenosis or Vasculitis

Required Sequences

Category A: 

Pulse Sequence and Image Contrast

Category B: 

Anatomic Coverage and Imaging Planes

Category C: 

Spatial Resolution

3D contrast-enhanced source images or 3D non-contrast MRA renal images

  • Must have good artery to background contrast

  • Must have minimal to no venous enhancement

  • Must have correct bolus timing if contrast-enhanced

  • Inflow-enhanced (SFFP)e.g.Inhance Suite (GE) NATIVE (Siemens), TRANCE or B-TRANCE (Philips), Time-SLIP, Time Space Angiography or TSA (Toshiba), VASC-ASL (Hitachi) sequences may replace gadolinium-enhanced sequences

Must cover:

  • Origin of celiac artery

  • Origin of superior mesenteric artery (SMA)

  • Right and left renal arteries to the branching in the renal hilum with no motion blurring

  • Slice thickness ≤ 3.0 mm

  • Reconstructed slice interval ≤ 1.5 mm

  • Voxel volume ≤ 6.0 mm3

3D reformatted images (Angiographic Images)

  • Must have good artery to background contrast

Must display:

  • Origin of celiac artery

  • Origin of superior mesenteric artery (SMA)

  • Right and left renal arteries

N/A



MRA High Resolution Arch/Carotid Contrast-Enhanced

If time-resolved MRA (e.g. TRICKS, TWIST) is submitted, only 2 contrast-enhanced series should be submitted, which must include: 
  1. Dynamic phases 
  2. Source images only from peak carotid enhancement phase

Required Sequences

Category A: 

Pulse Sequence and Image Contrast

Category B: 

Anatomic Coverage and Imaging Planes

Category C: 

Spatial Resolution

3D contrast-enhanced source images 

  • Must have good artery to background contrast

  • Must have uniform artery signal/ minimal to no intra-voxel phase dispersion

  • Must have minimal to no venous enhancement

  • Must have correct bolus timing

  • Inflow-enhanced (SFFP) e.g. Inhance Suite (GE), NATIVE (Siemens), TRANCE or B-TRANCE (Philips), Time-SLIP, Time Space Angiography or TSA (Toshiba), VASC-ASL (Hitachi) sequences may replace gadolinium-enhanced sequences

Must cover:

  • Aortic arch

  • Innominate artery

  • Right and left common carotid artery

  • Right and left carotid bifurcation

  • Right and left subclavian arteries 2 cm distal to the vertebral origins

  • Right and left vertebral arteries

  • Basilar artery

  • Circle of Willis

  • Slice thickness ≤ 2.0 mm

  • Reconstructed slice interval ≤ 1.0 mm

  • Reconstructed slice interval should be 50 % of the acquired slice thickness
  • Voxel volume ≤ 3.0 mm3

Reformatted contrast-enhanced angiographic images

  • Must have good artery to background contrast

  • Must have uniform artery signal

  • Must have minimal to no venous enhancement

Must display in multiple views and should be derived from the contrast MRA sequence:

  • Aortic arch

  • Innominate artery

  • Right and left common carotid artery

  • Right and left carotid bifurcation (each must be displayed in separate MIP reconstructions)

  • Right and left subclavian arteries 2 cm distal to the vertebral origins

  • Right and left vertebral arteries

  • Basilar artery

  • Circle of Willis

N/A



MRA Carotid Unenhanced

Required Sequences

Category A: 

Pulse Sequence and Image Contrast

Category B: 

Anatomic Coverage and Imaging Planes

Category C: 

Spatial Resolution

3D time of flight source images

  • Must have good artery to background contrast

  • Must have uniform artery signal

  • Must have minimal to no venous signal

  • A Hi-quality non-contrast MRA includes balanced steady state free precession and arterial spin labeling techniques and may replace 3D time of flight;   e.g. NATIVE (Siemens), Inhance Suite (GE), TRANCE or B- TRANCE (Philips), Time-SLIP or Time Space Angiography (Toshiba), VASC-ASL (Hitachi)

Must cover:

  • 2 cm of the right & left common carotid arteries

  • 3 cm of the right & left internal carotid arteries

  • 2 cm of the right & left external carotid arteries

  • Slice thickness ≤ 1.6 mm

  • Voxel volume ≤ 1.7 mm3

3D time of flight reformatted images (angiographic images)

  • Must have good artery to background contrast

  • Must have uniform artery signal

  • Must have minimal to no venous signal

  • Must display in multiple views:

    • 2 cm of the right & left common carotid arteries

    • 3 cm of the right & left internal carotid arteries

    • 2 cm of the right & left external carotid arteries

  • Must show adequate segmentation of carotid arteries such that each artery segment is visible in multiple views with no overlap from other vessels

  • The right & left carotid should be segmented separately

N/A

2D time of flight multi-slab source images

  • Must have good artery to background contrast

  • Must have uniform artery signal

  • Must have minimal to no venous signal

Must cover:

  • 4 cm of the right & left common carotid arteries

  • right & left internal carotid arteries to the petrous bone

  • right & left external carotid arteries

  • right & left vertebral arteries

  • Slice thickness ≤ 2.0 mm

  • Gap ≤ 0 mm

  • Pixel area ≤ 1.1 mm2


2D time of flight reformatted images (angiographic images)

  • Must have good artery to background contrast

  • Must have uniform artery signal

  • Must have minimal to no venous signal

  • Must display in multiple views:

    • 4 cm of the right & left common carotid arteries

    • right & left internal carotid arteries to the petrous bone

    • right & left external carotid arteries

    • right & left vertebral arteries

  • Must show adequate segmentation of carotid arteries such that each artery segment is visible in multiple views with no overlap from other vessels

  • The right & left carotid should be segmented separately

N/A



MRA Thoracic Aorta

Required Sequences

Category A: 

Pulse Sequence and Image Contrast

Category B: 

Anatomic Coverage and Imaging Planes

Category C: 

Spatial Resolution

Non-contrast black or bright blood source images

  • Must have good artery to background contrast

  • Must have uniform artery signal

  • Must have minimal to no venous signal

Must cover:

  • 2 cm of the origins of the arch vessels

  • Entire thoracic aorta from the aortic annulus to the diaphragmatic hiatus

  • Slice thickness ≤ 7.0 mm

  • Gap ≤ 1.5 mm

  • Pixel area ≤ 3.0 mm2

3D contrast enhanced source images

  • Must have good artery to background contrast

  • Must have uniform artery signal

  • Must have minimal to no venous enhancement

  • Must have correct bolus timing

Must cover:

  • 2 cm of the origins of the arch vessels

  • Entire thoracic aorta from the aortic annulus to the diaphragmatic hiatus

  • Slice thickness ≤ 3.4 mm

  • Reconstructed slice interval ≤ 1.7 mm

  • Voxel volume ≤ 20.0 mm3

3D contrast enhanced reformatted images (angiographic images)

  • Must have good artery to background contrast

  • Must have uniform artery signal

  • Must have minimal to no venous enhancement

Must display in multiple views:

  • 2 cm of the origins of the arch vessels

  • Entire thoracic aorta from the aortic annulus to the diaphragmatic hiatus

N/A





Revision History for this Article

Date

Section

Description of Revision(s)

12-12-19

All

Article created; FAQs incorporated; No criteria changes

12-19-19MRA Abdomen for Renal Artery Stenosis or VasculitisRemoved "Contrast Enhanced" from 3D reformatted images (Angiographic Images) sequence description.




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