(MRA) Magnetic resonance angiography is a medical imaging technique to visualize blood filled structures, including arteries, veins and the heart chambers. This MRI technique creates soft tissue contrast between blood vessels and surrounding tissues primarily created by flow, rather than displaying the vessel lumen. There are bright blood and black blood MRA techniques, named according to the appearance of the blood vessels. With this different MRA techniques both, the blood flow and the condition of the blood vessel walls can be seen. Flow effects in MRI can produce a range of artifacts. MRA takes advantage of these artifacts to create predictable image contrast due to the nature of flow.
Technical parameters of the MRA sequence greatly affect the sensitivity of the images to flow with different velocities or directions, turbulent flow and vessel size.
This are the three main types of MRA:
All angiographic techniques differentially enhance vascular MR signal. The names of the bright blood techniques TOF and PCA reflect the physical properties of flowing blood that were exploited to make the vessels appear bright. Contrast enhanced magnetic resonance angiography creates the angiographic effect by using an intravenously administered MR contrast agent to selectively shorten the T1 of blood and thereby cause the vessels to appear bright on T1 weighted images.
MRA images optimally display areas of constant blood flow-velocity, but there are many situations where the flow within a voxel has non-uniform speed or direction. In a diseased vessel these patterns are even more complex. Similar loss of streamline flow occurs at all vessel junctions and stenoses, and in regions of mural thrombosis. It results in a loss of signal, due to the loss of phase coherence between spins in the voxel.
This signal loss, usually only noticeable distal to a stenosis, used to be an obvious characteristic of MRA images. It is minimized by using small voxels and the shortest possible TE. Signal loss from disorganized flow is most noticeable in TOF imaging but also affects the PCA images.
Indications to perform a magnetic resonance angiography (MRA):
Conventional angiography or computerized tomography angiography (CT angiography) may be needed after MRA if a problem (such as an aneurysm) is present or if surgery is being considered.

See also Magnetic Resonance Imaging MRI.

(MRI-CA) Coronary angiography with dobutamine stress tagging (MR images are taken after the heart has been stressed by using a medication called dobutamine). Investigational noninvasive imaging as a diagnostic tool for evaluating stenosis, anatomy and flow effects in coronary arteries with dobutamine stress.

For Ultrasound Imaging (USI) see Stress Echocardiogram at Medical-Ultrasound-Imaging.com.

(I MRA) In MR imaging, inflowing non-saturated fluid gives a higher signal intensity than stationary tissue. This effect makes it especially useful for imaging of flowing blood. Other factors such as susceptibility and spin saturation, can affect the signal of the blood within the vessels. Furthermore turbulence is part of normal blood flow and can decrease signal intensity.

See also Time of Flight Angiography.

For a contrast enhanced MR angiography of the peripheral blood vessels, the patient reclines on a moveable table that moves under the MR machine to provide images of the abdomen, upper and lower legs in one procedure. A time optimized 3D gradient echo protocol with contrast agent and tabletop movement in several stages is used.

(CENTRA) A special form of k-space acquisition especially for contrast enhanced MRA. Longer scan times for high image resolution is possible, without a venous overlay, because the vast majority of contrast information is acquired only in the first seconds, the remaining scan time is used for resolution.