(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.

Flow phenomena are intrinsic processes in the human body. Organs like the heart, the brain or the kidneys need large amounts of blood and the blood flow varies depending on their degree of activity. Magnetic resonance imaging has a high sensitivity to flow and offers accurate, reproducible, and noninvasive methods for the quantification of flow. MRI flow measurements yield information of blood supply of of various vessels and tissues as well as cerebro spinal fluid movement.
Flow can be measured and visualized with different pulse sequences (e.g. phase contrast sequence, cine sequence, time of flight angiography) or contrast enhanced MRI methods (e.g. perfusion imaging, arterial spin labeling).
The blood volume per time (flow) is measured in: cm3/s or ml/min. The blood flow-velocity decreases gradually dependent on the vessel diameter, from approximately 50 cm per second in arteries with a diameter of around 6 mm like the carotids, to 0.3 cm per second in the small arterioles.

Different flow types in human body:
See also Flow Effects, Flow Artifact, Flow Quantification, Flow Related Enhancement, Flow Encoding, Flow Void, Cerebro Spinal Fluid Pulsation Artifact, Cardiovascular Imaging and Cardiac MRI.

Lung imaging is furthermore a challenge in MRI because of the predominance of air within the lungs and associated susceptibility issues as well as low signal to noise of the inflated lung parenchyma. Cardiac and respiratory triggered or breath hold sequences allow diagnostic imaging, however a comparable image quality with computed tomography is still difficult to achieve.
Assumptions for lung MRI:
The current trends in MRI are the use of new imaging technologies and increasingly powerful magnetic fields. Among these technologies are parallel imaging techniques as well as ventilation agents like hyperpolarized helium for the use as an inert inhalational contrast agent to study lung ventilation properties. With hyperpolarized gases clear images of the lungs can be obtained without using a large magnetic field (see also back projection imaging). Single shot sequences (e.g. TSE or Half Fourier Acquisition Single Shot Turbo Spin Echo HASTE) used in lung MR imaging benefits from parallel imaging techniques due to reduced relaxation time effects during the echo train and therefore reduced image blurring as well as reduced motion artifacts.
In the future, more effective contrast agents may provide an alternative solution to the need for high field MRI. Dynamic contrast enhanced MRI perfusion has demonstrated a potential in the diagnosis of pulmonary embolism or to characterize lung cancer and mediastinal tumors. 3D contrast enhanced magnetic resonance angiography of the thoracic vessel.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'

(bFFE) A FFE sequence using a balanced gradient waveform. A balanced sequence starts out with a RF pulse of 90° or less and the spins in the steady state. Before the next TR in the slice phase and frequency encoding, gradients are balanced so their net value is zero. Now the spins are prepared to accept the next RF pulse, and their corresponding signal can become part of the new transverse magnetization. Since the balanced gradients maintain the transverse and longitudinal magnetization, the result is, that both T1 and T2 contrast are represented in the image. This pulse sequence produces images with increased signal from fluid, along with retaining T1 weighted tissue contrast. Because this form of sequence is extremely dependent on field homogeneity, it is essential to run a shimming prior the acquisition. A fully balanced (refocused) sequence would yield higher signal, especially for tissues with long T2 relaxation times.

See Steady State Free Precession and Gradient Echo Sequence.

(BOLD) In MRI the changes in blood oxygenation level are visible. Oxyhaemoglobin (the principal haemoglobin in arterial blood) has no substantial magnetic properties, but deoxyhaemoglobin (present in the draining veins after the oxygen has been unloaded in the tissues) is strongly paramagnetic. It can thus serve as an intrinsic paramagnetic contrast agent in appropriately performed brain MRI. The concentration and relaxation properties of deoxyhaemoglobin make it a susceptibility , e.g. T2 relaxation effective contrast agent with little effect on T1 relaxation.
During activation of the brain, the oxygen consumption of the local tissue increase by approximately 5% with that the oxygen tension will decrease. As a consequence, after a short period of time vasodilatation occurs, resulting in a local increase of blood volume and flow by 20 - 40%. The incommensurate change in local blood flow and oxygen extraction increases the local oxygen level.
By using T2 weighted gradient echo EPI sequences, which are highly susceptibility sensitive and fast enough to capture the three-dimensional nature of activated brain areas will show an increase in signal intensity as oxyhaemoglobin is diamagnetic and deoxyhaemoglobin is paramagnetic. Other MR pulse sequences, such as spoiled gradient echo pulse sequences are also used.
As the effects are subtle and of the order of 2% in 1.5 T MR imaging, sophisticated methodology, paradigms and data analysis techniques have to be used to consistently demonstrate the effect.
As the BOLD effect is due to the deoxygenated blood in the draining veins, the spatial localization of the region where there is increased blood flow resulting in decreased oxygen extraction is not as precisely defined as the morphological features in MRI. Rather there is a physiological blurring, and is estimated that the linear dimensions of the physiological spatial resolution of the BOLD phenomenon are around 3 mm at best.