(
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):
•
Detection of aneurysms and dissections
•
Evaluation of the vessel anatomy, including variants
•
Blockage by a blood clot or stenosis of the blood vessel caused by plaques (the buildup of fat and calcium deposits)
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.