Background Information:

What are the other Names for the Procedure?

• Magnetic Resonance Angiography
• MR Angiogram
• MRA (Magnetic Resonance Angiogram)

What is Magnetic Resonance Angiogram radiology procedure? (General Explanation)

• A Magnetic Resonance Angiogram (MRA) radiology procedure is an advanced imaging technique that uses information and inputs from magnetic resonance imaging (MRI), in order to better evaluate the blood vessels of various parts of the body
• Instead of using X-ray radiation, the MRA procedure uses magnetic field and radio waves to produce detailed images of the body parts
• An MRA radiology procedure can be performed with or without the use of a contrast material

What part of the Body does Procedure involve?

A Magnetic Resonance Angiogram radiology procedure can involve the arterial and venous systems of various organs including the brain, heart, lungs, kidneys, intestines, or even arms or legs

Why is the Magnetic Resonance Angiogram radiology procedure Performed?

The Magnetic Resonance Angiogram procedure is performed for the following purposes:

• To produce detailed images of blood vessels of different parts of the body
• Identify blockages in the blood supply of the brain, such as in a stroke
• To identify lipid deposits or plaque in the arteries of legs
• To identify diseases and medical conditions, such as atherosclerosis or aneurysm, in the arteries
• To identify arteriovenous malformation
• Used during kidney transplantation, coronary bypass, and stent implantation
• Identify injuries in arteries during trauma
• Identify a pulmonary embolism
• Detect blood flow to the intestines, kidneys, or arteries supplying blood to the tumors

What are the Alternative Choices for the Procedure?

Other potential alternative procedures for an MRA may include:

• Computed tomography angiography (CT angiography)
• Catheter angiography

What is the Equipment used? (Description of Equipment)

The equipment used for a Magnetic Resonance Angiogram radiology procedure includes the following:

• MRI equipment: It consists of a large cylinder-shaped tube that is surrounded by a circular magnet
• The individual lies on a table that slides back and forth in the cylinder tube
• The procedure may or may not require an IV line for administering a contrast

What are the Recent Advances in the Procedure?

The recent advances in the technology of MRI have made magnetic resonance imaging quicker, thereby making a Magnetic Resonance Angiogram more feasible.

What is the Cost of performing the Magnetic Resonance Angiogram radiology procedure?

The cost of a Magnetic Resonance Angiogram procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding a Magnetic Resonance Angiogram and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Wehrli FW, Shimakawa A, MacFall JR, Axel L, Perman W. MR imaging of venous and arterial flow by a selective saturation-recovery spin echo (SSRSE) method. J Comput Assist Tomogr. 1985;9(3):537-545. (accessed Feb 1, 2017)

Dumoulin CL, Hart HR. Magnetic resonance angiography. Radiology. 1986;161(3):717-720. Accessed Feb 1, 2017. doi: 10.1148/radiology.161.3.3786721.

Prior to Magnetic Resonance Angiogram radiology procedure:

How does the Magnetic Resonance Angiogram radiology procedure work?

The Magnetic Resonance Angiogram radiology procedure works in the following manner:

• The MRI equipment uses magnet fields instead of ionizing radiation
• Electrical current passes through the coils in order to produce a magnetic field
• Other coils send and receive radio waves and signals that are detected by the coils
• A computer processes the signals and generates images showing a thin slice of body
• If contrast is used, the material changes the signal produced from blood to brighter image, allowing the radiologist to see the blood vessels more clearly

How is the Magnetic Resonance Angiogram radiology procedure Performed?

The Magnetic Resonance Angiogram (MRA) radiology procedure is performed as follows:

• The patient is positioned on the moveable examination table
• An IV line may be inserted into the patient’s arm, if contrast material is required for the procedure
• The patient is moved into the MRI unit and images are taken, while the radiologist is checking the images in an adjacent room
• The patient should remain still during the procedure, in order to avoid any blurriness of the images being produced

Where is the Procedure Performed?

The Magnetic Resonance Angiogram procedure is performed as either an inpatient or outpatient procedure at a hospital.

Who Performs the Procedure?

A Magnetic Resonance Angiogram radiology procedure is usually performed by a radiology technologist, under the supervision of a radiologist.

How long will the Procedure take?

The duration of a Magnetic Resonance Angiogram radiology procedure varies based on the area of the body being imaged, but in general, takes less than an hour to perform.

Who interprets the Result?

A radiologist analyzes the images and informs the physician, who will then inform the patient.

What Preparations are needed, prior to Procedure?

The following preparations may be needed prior to a Magnetic Resonance Angiogram radiology procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
• It is advisable to wear comfortable and loose clothes; the individual may be asked to change into a hospital gown. Avoid wearing any metal objects or jewelry, as it may interfere with the scan
• It is recommended to notify the physician about any implants or metal objects in the body, such as a pacemaker, nerve simulators, surgical staples, or artificial heart valves, braces, or dyed tattoos, as they may interfere with the imaging, in some cases
• Those with metal objects in their body may be required to have an X-ray taken, before the MRI scan. In many cases, having a metal object in the body is a contraindication for performing an MRI scan
• Patients are usually asked not to eat or drink anything several hours before the exam
• Women should notify the physician, if they are pregnant or breastfeeding their child; as many such procedures, may not be performed on pregnant women

What is the Consent Process before the Procedure?

A physician will request your consent for the Magnetic Resonance Angiogram procedure using an Informed Consent Form.

Consent for the procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the procedure:

• It is a non-invasive procedure
• There is no need of a catheter
• X-ray radiation is not involved in this procedure
• The cost of this examination is less than that of a catheter angiography
• In most cases, it produces detailed images of blood vessels without the use of a contrast material
• Even if contrast material is used in the procedure, having an allergic reaction due to the contrast material is minimal, since an iodine-based contrast material is generally not used

Following are the risks of the procedure:

• The risks are generally minimal
• Unrecognized metal devices implanted in the body may cause problems during an MRI, since strong magnetic fields are employed
• There is a rare chance of having an allergic reaction, if a contrast material is used
• Very rarely, nephrogenic systemic fibrosis may occur in patients with poor kidney function, because of the gadolinium contrast material used in the procedure

What are the Limitations of the Magnetic Resonance Angiogram radiology procedure?

Following are the limitations of the procedure:

• It is hard to obtain images of small vessels with MRA
• It may be difficult to distinguish arteries from veins in images taken with an MRA
• The procedure cannot help obtain images of calcium deposits
• The MRA procedure is acutely movement-sensitive; even a little motion, may affect the quality of the image being taken

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is a Magnetic Resonance Angiogram procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• What are the costs involved?

During the Magnetic Resonance Angiogram radiology procedure:

What is expected during the Magnetic Resonance Angiogram radiology procedure?

The following may be expected during the Magnetic Resonance Angiogram radiology procedure:

• Some individuals may experience a warm flushing feeling during the imaging process
• If any pain is felt in association with this feeling, the technologist performing the scan should be alerted
• One may experience some anxiety due to the noise of the scanner and due to partial confinement within the narrow cylinder of the MRI equipment
• Generally, no pain is associated with the procedure

What kind of Anesthesia is given, during the Procedure?

In general, no anesthesia is administered during the procedure. Rarely, if a patient is too anxious to have the exam performed, or has a fear of enclosed spaces, the procedure may be performed with mild sedation.

How much Blood will you lose, during a Magnetic Resonance Angiogram?

There is no blood loss involved in a Magnetic Resonance Angiogram radiology procedure.

What are the possible Risks and Complications during the Magnetic Resonance Angiogram radiology procedure?

• There is only a minimal risk to the patient
• If anesthesia is administered, there is a slight risk of over-sedation. However, the patient will be carefully monitored throughout the duration of the procedure
• Extremely rarely, individuals with severely-compromised kidney function who receive the MRI contrast material, may develop a severe reaction known as nephrogenic systemic fibrosis

What Post-Operative Care is needed at the Healthcare Facility after the Magnetic Resonance Angiogram radiology procedure?

• In most cases, no post-operative care is required at the healthcare facility, after the MRA
• However, if the patient is experiencing an allergic reaction from the contrast reaction, then the attending physician should be immediately contacted

After the Magnetic Resonance Angiogram radiology procedure:

What is to be expected after the Magnetic Resonance Angiogram radiology procedure?

Generally, no complications or side effects are observed after a Magnetic Resonance Angiogram radiology procedure.

When do you need to call your Physician?

If the patient experiences an allergic reaction from the contrast agent, then the physician must be contacted immediately.

What Post-Operative Care is needed at Home after the Magnetic Resonance Angiogram radiology procedure?

There is no post-operative care required at home, after a Magnetic Resonance Angiogram radiology procedure.

How long does it normally take to fully recover, from the Procedure?

The patient needs no recovery time after a Magnetic Resonance Angiogram radiology procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue is extracted from the patient during a Magnetic Resonance Angiogram radiology procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Magnetic Resonance Angiogram radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the health care facility has with the physician and other health care providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• A radiologist, performing the procedure
• Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before a Magnetic Resonance Angiogram procedure is performed.