DICOM PS3.20 2021b - Imaging Reports using HL7 Clinical Document Architecture

9.8.6 Key Images (Current)
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### 9.8.6 Key Images

ID | 1.3.6.1.4.1.19376.​1.4.1.2.14
Name | Key Images
Effective Date | 2011-07
Version Label | DICOM-20150324
Status | Active
Description | The Key Images section contains narrative description of and references to DICOM Image Information Objects that illustrate the findings of the procedure reported.
Classification | CDA Section Level
Relationships | Included in 9.6 Impression
Context | parent node
Open/Closed | Open
Revision History | From IHE Cardiac Imaging Report Content DICOM-20150324: Addition of optional inline image (observationMedia)

Business Name | Nest Level | Element/​Attribute | Card | Elem/Attr Conf | Data Type | Value Conf | Value | Subsidiary Template
--- | --- | --- | --- | --- | --- | --- | --- | ---
Key​Images |  | section | 1..1 | SHALL |  |  |  |
| > | template​Id | 1..1 | SHALL | II |  |  |
| >@ | @root | 1..1 | SHALL | UID | SHALL | 1.3.6.1.4.1.19376.​1.4.1.2.14 |
| > | id | 1..* | SHALL | II |  |  |
| > | code | 1..1 | SHALL | CD | SHALL | (55113-5, LOINC, "Key Images") |
Title | > | title | 1..1 | SHALL | ST |  |  |
Text | > | text | 1..1 | COND | ED |  |  | 9.1.1 Section Text 1.2.840.10008.9.19
| > | entry | 0..* | SHOULD |  |  |  |
SOPInstance[*] | >> | observation | 1..1 | SHALL |  |  |  |
| > | entry | 0..* | MAY |  |  |  |
Graphic[*] | >> | observation​Media | 1..1 | SHALL |  |  |  | 10.3 observationMedia 1.3.6.1.4.1.19376.​1.4.1.4.7

#### 9.8.6.1 Section/text

The Key Images section text SHALL contain image references using linkHtml elements, where @href is a valid Web Access to DICOM Persistent Object (WADO) URL. See Section 9.1.1.5. The text content of linkHtml should be either visible text of the hyperlink, or a descriptor or identifier of the image; it may be associated with a (limited resolution) copy of the image (see Section 9.8.6.3).

Example 9.8.6-1. Key Images section example

    <section classCode="DOCSECT" moodCode="EVN">>
    	<templateId root="1.3.6.1.4.1.19376.1.4.1.2.14" />
    	<id root="1.2.840.10213.2.62.704478559484.11428372623" />
    	<code code="55113-5"
    		codeSystem="2.16.840.1.113883.6.1"
    		codeSystemName="LOINC"
    		displayName="Key Images"/>
    	<title>Key Images</title>
    	<text>Maximum extent of tumor is shown in
    		<linkHtml href="http://www.example.org/wado?requestType=WADO&amp;...">image 1</linkHtml>
    		<renderMultiMedia referencedObject="refimag1"/>
    	</text>
    	<entry>
    		<!-- SOP Instance reference -->
    		<observation classCode=DGIMG moodCode=EVN ID="SOP1-2"/>
    	</entry>
    	<entry>
    		<!-- inline rendered image -->
    		<observationMedia ID="refimag1">
    			<value representation=B64 mediaType="image/jpeg">
    				Bgd3fsET4g...
    			</value>
    		</observationMedia>
    	</entry>
    </section>

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DICOM PS3.20 2021b - Imaging Reports using HL7 Clinical Document Architecture