Vascular disease
MR angiography (MRA) has now become the first-line tool for imaging the vasculature in many centers. Numerous studies have proven its accuracy for detecting disease in different vascular territories. In our institution, the carotid, aorta, pulmonary, mesenteric, renal, hepatic and lower extremity arteries are routinely evaluated with MRA and catheter-based x-ray angiography is reserved for interventional procedures.
Patients with vascular disease are screened first with the relatively non-invasive MRA test, thus avoiding direct arterial puncture and prolonged stays within the hospital. Furthermore, there is no ionizing radiation involved and the contrast agent used is relatively innocuous. Below are some examples of MRA studies in different vascular territories.
MRA of the upper extremity demonstrating segmental occlusion of the brachial artery.
MRA of mesenteric arteries demonstrating splenic artery aneurysm.
Time-resolved MRA of the lower extremities demonstrating the calf vessels. Each frame lasts five seconds and shows the runoff arteries fill and empty over time. Using this technique, it is now possible to simulate rapid frame rate angiography that interventionalists have been used to for years.