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Magnetic resonance angiography, head; with contrast material(s)

CPT4 code

Name of the Procedure

Magnetic Resonance Angiography (MRA) of the head with contrast material(s) Common name(s): MRA head with contrast, Magnetic resonance angiogram of the head

Summary

Magnetic Resonance Angiography (MRA) of the head with contrast is a non-invasive imaging test that uses powerful magnetic fields and contrast dye to visualize the blood vessels in the head. It is used to detect abnormalities such as aneurysms, blockages, and malformations in the blood vessels.

Purpose

The procedure is performed to evaluate the blood vessels in the head for:

  • Aneurysms
  • Stenosis (narrowing of blood vessels)
  • Arteriovenous malformations (AVMs)
  • Blood clots
  • Other vascular abnormalities

The goal is to diagnose vascular conditions, guide treatment plans, and monitor the effectiveness of interventions.

Indications

  • Symptoms such as severe headaches, dizziness, or visual disturbances
  • Suspected or known cerebrovascular diseases like aneurysms or strokes
  • Family history of vascular abnormalities
  • Pre-surgical planning for vascular surgeries
  • Follow-up on previously diagnosed vascular conditions

Preparation

  • Patients may be instructed to fast for a few hours before the procedure.
  • Certain medications may need to be adjusted; this is typically discussed with the doctor.
  • Pre-procedural assessments might include a detailed medical history and possibly blood tests.

Procedure Description

  1. The patient will change into a hospital gown and lie down on the MRI table.
  2. An intravenous (IV) line will be inserted to administer the contrast dye.
  3. The patient is positioned inside the MRI machine, and the area of the head to be scanned is centered.
  4. The MRI machine will generate images as the contrast dye is injected, highlighting blood vessels.
  5. The patient must remain still, as movement can affect image quality.
  6. The procedure is painless, but the machine makes loud noises; ear protection is provided.

Duration

The procedure typically takes between 30 to 60 minutes.

Setting

The procedure is performed in a hospital's radiology or imaging department or an outpatient imaging center.

Personnel

  • Radiologist (specialized in interpreting the images)
  • MRI technologist
  • Occasionally, a nurse to manage the IV line and contrast material

Risks and Complications

  • Allergic reaction to the contrast material (rare)
  • Mild discomfort or bruising at the injection site
  • Claustrophobia (anxiety related to being in the MRI machine)
  • Rarely, nephrogenic systemic fibrosis in patients with severe kidney disease

Benefits

  • Provides detailed images of blood vessels, aiding in accurate diagnosis and treatment planning.
  • Non-invasive with no exposure to ionizing radiation.
  • Early detection of vascular conditions can lead to better outcomes.

Recovery

  • Typically, no recovery time is needed.
  • Patients can resume normal activities immediately unless instructed otherwise.
  • Drink plenty of fluids to help flush out the contrast dye.
  • Follow-up appointments may be scheduled to discuss results with the doctor.

Alternatives

  • CT Angiography: Uses X-rays and may be quicker but involves ionizing radiation.
  • Doppler Ultrasound: Non-invasive but less detailed than MRA.
  • Conventional Angiography: More invasive, involving catheter insertion, but provides detailed information useful for certain cases.

Patient Experience

During the procedure, the patient may hear loud noises from the MRI machine and feel a cool sensation when the contrast dye is injected. Post-procedure, most patients feel normal and can return to their daily activities. Comfort measures, such as earplugs and communication via an intercom system, help ensure the patient's comfort during the scan.

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