Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences
CPT4 code
Name of the Procedure:
Magnetic Resonance Angiography (MRA) of the Neck; without contrast material(s), followed by contrast material(s) and further sequences.
Summary
Magnetic Resonance Angiography (MRA) of the neck is a non-invasive imaging technique used to visualize blood vessels in the neck area. Initially, images are taken without any contrast material, followed by additional imaging sequences after a contrast material is injected to enhance the visibility of blood vessels.
Purpose
Medical Condition or Problem Addressed:
Detect and diagnose disorders of the blood vessels in the neck, such as stenosis (narrowing), occlusions (blockages), aneurysms, and other vascular abnormalities.
Goals or Expected Outcomes:
- Provide detailed imagery of blood vessels to help diagnose and plan treatment for vascular conditions.
- Enhance diagnostic accuracy and guide potential interventions.
Indications
Symptoms or Conditions:
Symptoms like dizziness, headaches, blurred vision, transient ischemic attacks (TIAs), or stroke-like symptoms.
Patient Criteria or Factors:
- Patients with suspected or existing vascular diseases.
- Patients referred for follow-up after previous findings of vascular issues in the neck.
Preparation
Pre-procedure Instructions:
- Fasting for 4-6 hours before the procedure may be required.
Bring a list of all medications; some adjustments might be necessary (e.g., blood thinners).
Diagnostic Tests and Assessments:
- Blood tests may be required to ensure kidney function is normal, as contrast material is processed through the kidneys.
- Previous imaging results, if any, should be reviewed.
Procedure Description
Step-by-Step Explanation:
- Initial Imaging: The patient lies on a table that slides into the MRI machine. Initial images are taken without contrast material.
- Contrast Injection: A contrast material is injected into a vein, often in the arm.
Further Sequences: Additional images are taken to enhance visualization of blood vessels.
Tools, Equipment, and Technology:
- MRI machine, contrast material, and monitoring equipment.
Anesthesia or Sedation:
- Generally, no anesthesia or sedation is required.
Duration
- The entire procedure typically takes about 45-60 minutes.
Setting
- Performed in a hospital or specialized imaging center with MRI facilities.
Personnel
- Radiologists, MRI technicians, and nurses.
Risks and Complications
Common Risks:
Mild discomfort or allergic reaction to the contrast material (rare).
Possible Complications:
- Very rare renal complications in patients with pre-existing kidney issues.
- Allergic reactions can be managed with medication and close monitoring.
Benefits
Expected Benefits:
- Highly detailed images of the blood vessels for accurate diagnosis.
- Results are usually available quickly and can guide treatment plans.
Recovery
Post-procedure Care and Instructions:
- Monitor for any delayed allergic reactions for a few hours after the procedure.
Resume normal activities almost immediately after the procedure.
Expected Recovery Time:
Usually, no significant recovery time needed.
Follow-up Appointments:
- Based on the results, follow-up with your doctor to discuss findings and next steps.
Alternatives
Other Treatment Options:
CT Angiography (CTA), Ultrasound of the neck vessels (Carotid Doppler), or standard MRI without contrast.
Pros and Cons of Alternatives:
- CTA provides good detail but exposes the patient to ionizing radiation.
- Ultrasound is non-invasive but may not provide as detailed images as an MRA.
Patient Experience
During the Procedure:
- Patients will need to lie still inside a narrow MRI tunnel; some may feel claustrophobic.
Mild cold sensation when the contrast material is injected.
After the Procedure:
- Generally minimal discomfort or side effects.
- Any pain management, if required, will be minimal and addressed immediately.
Comfort Measures:
- Earplugs or headphones provided to mitigate noise from the MRI machine.
- Communication with the MRI technician throughout the procedure for reassurance and comfort.