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Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)

CPT4 code

Name of the Procedure:

Magnetic Resonance Angiography (MRA), Spinal Canal and Contents, with or without Contrast Material

  • Common Name(s): Spinal MRA
  • Technical / Medical Terms: Magnetic resonance angiography of the spinal canal

Summary

Magnetic Resonance Angiography (MRA) of the spinal canal is a non-invasive imaging procedure that uses powerful magnets and radio waves to produce detailed images of the blood vessels in and around the spinal canal. The procedure may be performed with or without the use of contrast material to enhance the visibility of the blood vessels.

Purpose

  • Medical Condition or Problem: Diagnoses conditions such as spinal vascular malformations, aneurysms, and stenosis.
  • Goals or Expected Outcomes: To provide detailed images of the blood vessels within the spinal canal, aiding in precise diagnosis and treatment planning.

Indications

  • Symptoms such as unexplained back pain, weakness, numbness, or paralysis.
  • Conditions like suspected spinal stenosis, vascular malformations, or aneurysms.
  • Abnormal findings in other imaging studies that require further investigation.

Preparation

  • Pre-procedure Instructions: Patients may be asked to refrain from eating or drinking for a few hours before the procedure.
  • Diagnostic Tests: No specific tests are typically required beforehand; however, patients should inform their healthcare provider about any implants or metal objects in their body due to MRI safety protocols.

Procedure Description

  1. Preparation: Patient changes into a hospital gown and removes any metal objects.
  2. Positioning: Patient lies on the MRI table.
  3. Scanning: The table slides into the MRI machine. If contrast is needed, it may be injected through an IV line.
  4. Imaging: The MRI machine uses magnetic fields and radio waves to create detailed images of the spinal blood vessels.
  5. Completion: The MRI table slides out, and any IV lines are removed. Images are reviewed by a radiologist.
  • Tools and Equipment: MRI scanner, sometimes an intravenous (IV) contrast agent.
  • Anesthesia or Sedation: Usually not required, unless the patient has severe claustrophobia.

Duration

The procedure typically takes about 30 to 60 minutes, depending on whether contrast material is used.

Setting

Performed in a hospital radiology department or an outpatient imaging center.

Personnel

  • Radiologist
  • MRI Technologist
  • Nurses or other support staff if contrast material is administered

Risks and Complications

  • Common Risks: Mild discomfort or claustrophobia during the scan.
  • Rare Risks: Allergic reactions to contrast material, if used; issues related to implants or metal objects in the body.

Benefits

  • Expected Benefits: High-resolution images of the spinal blood vessels, aiding in accurate diagnosis.
  • Timeline for Benefits: Immediate analysis by radiologists, with results typically available within a few days.

Recovery

  • Post-Procedure Care: Minimal; patients can usually resume normal activities immediately.
  • Recovery Time: No recovery time needed unless sedatives were used.
  • Follow-Up: A follow-up appointment to discuss imaging results and next steps may be scheduled.

Alternatives

  • CT Angiography (CTA): Uses X-rays and may be quicker, but involves radiation exposure.
  • Conventional Angiography: Invasive, with higher risks compared to MRA.
  • Ultrasound: Limited by poor penetration of the spinal canal's bony structures.

Patient Experience

  • During the Procedure: Patients lie still in a confined space; may hear loud tapping or thumping noises.
  • After the Procedure: Generally, no pain or discomfort is expected. Normal activities can typically be resumed immediately. Pain management is generally not required.

Medical Policies and Guidelines for Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)

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