Magnetic resonance angiography (MRA) is a group of techniques based on Magnetic Resonance Imaging (MRI) to image blood vessels. Magnetic resonance angiography is used to generate images of the arteries in order to evaluate them for stenosis (abnormal narrowing), occlusion or aneurysms (vessel-wall dilatations, at risk of rupture). MRA is often used to evaluate the arteries of the neck and brain, the thoracic and abdominal aorta, the renal arteries, and the legs (called a "run-off").
- Contrast enhanced (CE-MRA): Injection of MRI contrast agents is currently the most common method of acquiring MRA. The contrast medium is injected into a vein, and images are acquired during the first pass of the agent through the arteries. Provided that the timing is correct, this may result in images of very high quality. An alternative is to use a contrast agent that does not, as most agents, leave the vascular system within a few minutes, but remains in the circulation up to an hour (a "'blood-pool agent'"). Since longer time is available for image acquisition, higher resolution imaging is possible. A problem, however, is the fact that both arteries and veins are enhanced at the same time.
- Time-of-flight (TOF) or Inflow angiography: uses a short echo time and flow compensation to make flowing blood much brighter than stationary tissue. As flowing blood enters the area being imaged it has seen a limited number of excitation pulses so it is not saturated, this gives it a much higher signal than the saturated stationary tissue. As this method is dependent on flowing blood, areas with slow flow (such as large aneurysms) or flow that is in plane of the image may not be well visualized. This is most commonly used in the head and neck and gives detailed high resolution images.
- Phase-contrast (PC-MRA): The phase of the MRI signal is manipulated by special bipolar gradients (varying magnetic fields) that is preset to a maximum expected flow velocity. An image acquisition that is reverse of the bipolar gradient is then acquired and the difference of the two image is calculated. Static tissues such as muscle or bone will subtract out, however moving tissues such as blood will acquire a different phase since it moves constantly through the gradient, thus also giving its speed of the flow. Since phase-contrast can only acquire flow in one direction at a time, three separate image acquisitions in all three directions must be computed to give the complete image of flow. Despite the slowness of this method, the strength of the technique is that in addition to imaging the flowing blood, quantitative measurements of blood flow occur at the same time.
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