Magnetic resonance angiography, lower extremity, with or without contrast material(s)
CPT4 code
Name of the Procedure:
Magnetic Resonance Angiography (MRA) of the Lower Extremity
- Other names: Magnetic Resonance Angiography with or without contrast, Lower Limb MRA
Summary
Magnetic Resonance Angiography (MRA) of the lower extremity is a non-invasive imaging technique used to visualize the blood vessels in the legs. The procedure can be performed with or without the use of contrast material to enhance image clarity.
Purpose
MRA is used to diagnose and evaluate conditions affecting the blood vessels of the legs, such as blockages, abnormalities, or aneurysms. The goal is to provide detailed images that help in planning treatments or surgeries, and to monitor the effectiveness of previous interventions.
Indications
- Intermittent claudication (leg pain during walking)
- Rest pain in the legs
- Non-healing leg ulcers
- Suspected peripheral artery disease (PAD)
- Swelling or discoloration of the legs
- Follow-up evaluation after vascular surgery or intervention
Preparation
- Fasting may be required for 4-6 hours prior to the procedure if contrast material is used.
- Inform the doctor of any allergies, particularly to contrast dyes.
- Avoid wearing metal objects (jewelry, watches) during the scan.
- Complete a checklist for any implanted medical devices (e.g., pacemakers).
Procedure Description
- Preparation: The patient lies on the MRI table, and coils may be placed around the legs for improved image quality.
- Contrast Injection: If contrast is used, it is injected intravenously; typically, gadolinium-based agents are used.
- Scanning: The MRI machine uses a magnetic field and radio waves to produce detailed images of the blood vessels.
- Monitoring: Technicians monitor the patient's status and images from a separate room.
Duration
The procedure typically takes about 30-60 minutes.
Setting
The procedure is performed in a hospital or outpatient imaging center equipped with MRI technology.
Personnel
Involved healthcare professionals include radiologists, MRI technologists, and sometimes nurses.
Risks and Complications
- Common Risks: Discomfort from lying still, feelings of claustrophobia.
- Rare Risks: Allergic reactions to contrast dye, nephrogenic systemic fibrosis (a rare condition related to gadolinium), minor issues from contrast injection like localized pain or swelling.
Benefits
- Detailed Imaging: Provides detailed and accurate images of the blood vessels.
- Non-invasive: Unlike traditional angiography, there’s no need for catheter insertion.
- No Radiation: Uses magnetic fields instead of X-rays, reducing radiation exposure.
Recovery
- Patients can typically return to normal activities immediately, unless sedation was used.
- Instructions may include drinking plenty of fluids to help flush out the contrast material.
- Follow-up appointments might be scheduled to discuss results.
Alternatives
- CT Angiography: Uses computed tomography for imaging, involving radiation exposure.
- Doppler Ultrasound: Non-invasive and radiation-free but less detailed.
- Traditional Angiography: Invasive procedure with catheter insertion but provides direct visualization and treatment options.
Patient Experience
During the scan, patients may feel slight warmth or hear loud tapping noises from the MRI machine. Earplugs or headphones are usually provided to reduce noise discomfort. Post-procedure, there may be minimal soreness if contrast was used. Overall, the procedure is generally well-tolerated with minimal pain.