Name of the Procedure:

Magnetic Resonance Angiography, Head; without Contrast Material(s), followed by Contrast Material(s) and Further Sequences
Common name: MRA of the head with and without contrast

Summary

Magnetic Resonance Angiography (MRA) of the head is a non-invasive imaging procedure that uses magnetic fields and radio waves to produce detailed images of the blood vessels in the head. The procedure is first done without contrast material, followed by the administration of a contrast agent for enhanced imaging.

Purpose

The purpose of an MRA of the head is to visualize the blood vessels in the brain and surrounding areas to diagnose and monitor conditions such as aneurysms, stenosis, or other vascular abnormalities. The goal is to obtain clear images that help in making accurate diagnoses and planning appropriate treatments.

Indications

• Symptoms such as severe headaches, dizziness, or visual disturbances
• Suspected or known cerebral aneurysms
• Evaluation of blood vessel abnormalities or malformations
• Monitoring of treated blood vessel conditions
• Suspected stroke or vascular blockages

Preparation

• Patients may be asked to fast for a few hours before the procedure.
• It is important to inform the healthcare provider of any metal implants and devices.
• Previous diagnostic tests, such as CT scans or basic blood work, might be reviewed.
• Patients should remove any metal objects and change into a hospital gown.

Procedure Description

1. The patient lies down on an examination table that slides into the MRI scanner.
2. Initial images are taken without the contrast material.
3. A contrast agent is then injected into the patient's vein to enhance image clarity.
4. Additional images are taken following the injection of contrast material.
5. The patient needs to remain still throughout the process to ensure clear images.

Equipment: MRI scanner, contrast agent

Anesthesia: Typically none, although some patients might require mild sedation if they experience claustrophobia.

Duration

The procedure typically takes between 45 to 90 minutes.

Setting

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

Personnel

• Radiologist (interprets the images)
• MRI technician (operates the MRI scanner)
• Nurse (administers the contrast material)
• Radiology nurse or aide (provides patient care and support)

Risks and Complications

• Rare allergic reactions to the contrast material
• Potential for renal complications in patients with pre-existing kidney conditions
• Claustrophobia or discomfort during the procedure

Benefits

• Non-invasive, detailed visualization of blood vessels
• Helps in accurate diagnosis and effective treatment planning
• Immediate results that can be reviewed by a healthcare provider

Recovery

• Most patients can return to their normal activities immediately after the procedure.
• Patients should drink plenty of fluids to help flush out the contrast material.
• Any specific aftercare instructions will be provided by the healthcare provider.

Alternatives

• CT Angiography (CTA): Uses X-rays and iodine-based contrast
  • Pros: Faster, useful for emergency diagnosis
  • Cons: Exposure to radiation, not as detailed in soft tissue
• Doppler Ultrasound: Uses sound waves to visualize blood flow
  • Pros: No radiation, simple procedure
  • Cons: Less detailed, limited by patient’s anatomy and ability to hold still

Patient Experience

• During the procedure: Patients may hear loud knocking or clicking sounds from the MRI machine; earplugs or headphones are usually provided. Patients might feel a cool sensation from the contrast injection.
• After the procedure: Normal activities can typically be resumed immediately. Some might experience minor discomfort at the injection site.

Pain management and comfort measures include adjusted positioning, listening to music through headphones, and, if necessary, mild sedation for anxiety.