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Magnetic resonance angiography (MRA) encompasses several imaging techniques based on magnetic resonance imaging (MRI) developed for studying the arterial and venous systems. The benefits of an MRA in comparison to traditional angiography is that it is noninvasive, it lacks ionizing radiation exposure, it has the potential for a non-contrast examination and it has the ability of high-resolution volumetric images. The MRA gadolinium contrast material is less likely to cause an allergic reaction than the iodine-based contrast materials used for computed tomography scanning. This activity illustrates the technical aspects of MR angiography, its use, and its role in specific diagnostic scenarios. Objectives: Identify the indications and contraindications of MR angiography. Describe the physics of the different MR angiography techniques. Outline the potential complications and clinical significance of MR angiography. Review interprofessional team strategies for improving care coordination and the use of MR angiography to improve diagnostic outcomes. Access free multiple choice questions on this topic.

Magnetic resonance angiography (MRA) encompasses several imaging techniques based on magnetic resonance imaging (MRI) developed for studying the arterial and venous systems. The benefits of an MRA in comparison to traditional angiography is that it is noninvasive, it lacks ionizing radiation exposure, it has the potential for a non-contrast examination, and it has the ability of high-resolution volumetric images. The MRA gadolinium contrast material is less likely to cause an allergic reaction than the iodine-based contrast materials used for computed tomography scanning. In this review, the different techniques for MRA are discussed, and the indications for different pathologies are disclosed.

MRA has similar complications as with MRI exams. A meta-analysis of 716,978 contrast-enhanced MRI exams from 9 studies revealed an overall rate of allergic-like reactions of 9.2 per 10,000 administrations, and a rate of severe allergic-like reactions was 0.52 per 10,000 administrations.[38] A recent study reviewed the MRI-related adverse event reports received by the Food and Drug Administration during a 10-year period.[39] A total of 1,548 adverse events were recorded, which were divided into eight different categories. Thermal: Skin reddening, blisters, warming, or heating sensation; Acoustic: Hearing loss and/or tinnitus; Image Quality: Lost exams, inadequate images, or images attributed to the incorrect patient; Projectile: Objects were pulled into or attracted to the main static magnetic field; Mechanical: Falls, crush injuries, broken bones, cuts, or musculoskeletal injuries; Peripheral Nerve Stimulation: Nerve or muscle stimulation or patients experiencing tingling, twitching, or involuntary movements; Miscellaneous: Adverse event that can not be classified in any of the other categories; Unclear: Insufficient information was available to make conclusions regarding the connection to the MRI exam.

An MRA scan takes less time than traditional catheter angiography and requires no recovery period. MRA is less costly than catheter angiography. Collaboration with shared indication and decision making and communication are key elements for a good outcome. The MRA is usually recommended by a specialist treating a specific disorder. It is important to orient the patient about the procedure as some patients are afraid of the machine or have physical limitations. Some patients are unable to lie flat or stay in the position for a long period of time. It is very important for the referring physician to clearly annotate the indications for the study, so the neuroradiologist and MRA technician performs the preferred technique to yield the best diagnostic outcomes.