Name of the Procedure:

Common Name(s): Chest MRA without and with contrast
Technical/Medical Term: Magnetic Resonance Angiography (MRA) without contrast followed by with contrast, chest (excluding myocardium)

Summary

Magnetic Resonance Angiography (MRA) of the chest is a non-invasive imaging test that allows doctors to visualize blood vessels in the chest area. The procedure involves taking images first without contrast dye and then with contrast dye to enhance the clarity and detail of the blood vessels.

Purpose

Medical Conditions Addressed:

• Blockages or narrowing of blood vessels
• Aneurysms
• Blood vessel malformations
• Monitoring known vascular conditions

Goals/Outcomes:

• Diagnose conditions affecting chest blood vessels
• Plan or monitor treatment for vascular conditions
• Provide detailed images to assist in surgical planning

Indications

Symptoms/Conditions:

• Unexplained chest pain
• Shortness of breath
• Previous history of vascular disease
• Abnormal results from other imaging tests

Patient Criteria:

• Patients with suspected or known blood vessel abnormalities
• Patients who need detailed vascular imaging before surgery

Preparation

Pre-Procedure Instructions:

• Fasting for 4-6 hours prior to the procedure
• Continue taking regular medications unless advised otherwise by your doctor
• Inform the doctor about any allergies, especially to contrast dye

Diagnostic Tests/Assessments:

• Blood tests to check kidney function
• Review of previous imaging studies

Procedure Description

1. The patient lies on an MRA table which slides into a large tube-like machine.
2. Initial images are taken without contrast.
3. Contrast dye is then administered through an IV.
4. Additional images are taken with the contrast dye to enhance the visibility of blood vessels.
5. The patient needs to remain still during the imaging process.
6. The whole procedure is monitored by a radiologic technologist and a radiologist.

Tools/Equipment Used:

• MRI machine
• IV catheter for contrast dye administration

Anesthesia/Sedation:

• No general anesthesia; sedation may be used if the patient is claustrophobic

Duration

The procedure typically takes about 60-90 minutes.

Setting

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

Personnel

• Radiologist
• Radiologic Technologist
• Nurse (for IV insertion and monitoring)

Risks and Complications

Common Risks:

• Discomfort from lying still
• Minor risk of allergic reaction to the contrast dye

Rare Complications:

• Kidney dysfunction (in patients with pre-existing conditions)
• Injection site reactions
• Excessive contrast dye leakage

Benefits

Expected Benefits:

• Accurate and detailed imaging of blood vessels without invasive surgery
• Helps in early diagnosis and treatment planning
• Results are usually available shortly after the procedure

Recovery

Post-Procedure Care:

• Observation for a short period post-procedure, especially if contrast dye was used
• Drink plenty of fluids to help flush out contrast dye

Recovery Time:

• Immediate return to normal activities for most patients
• Follow-up appointment as advised by your doctor

Alternatives

Other Treatment Options:

• CT Angiography
• Conventional Angiography
• Ultrasound imaging of blood vessels

Comparison with Alternatives:

• MRA avoids exposure to ionizing radiation (unlike CT Angiography)
• Non-invasive compared to conventional Angiography

Patient Experience

During Procedure:

• Mild discomfort from lying still
• Possible slight warmth when contrast dye is injected

After Procedure:

• Typically minor or no discomfort
• Drink fluids to help expel the contrast dye from your body

Pain management and comfort measures will be provided as needed to ensure the patient remains comfortable throughout the process.