Name of the Procedure:

Magnetic Resonance Angiography (MRA) without Contrast Followed by with Contrast, Lower Extremity (C8914)
Common Name(s): MRA of the legs, Leg angiography
Medical Terms: Lower extremity MRA, Non-contrast MRA followed by contrast-enhanced MRA

Summary

An MRA of the lower extremities is a detailed imaging procedure used to visualize the blood vessels in your legs. It starts without using a contrast dye to get a detailed picture, and then the process is repeated with contrast to highlight any blockages or issues in blood flow.

Purpose

This procedure is crucial for diagnosing vascular conditions in the legs, such as blockages, aneurysms, or stenosis. The expected outcome is to obtain clear images that help in planning treatment options like surgery or medication management.

Indications

Symptoms:

• Persistent leg pain
• Swelling in the legs
• Cold or numb extremities
• Non-healing wounds or ulcers on legs

Patient Criteria:

• Suspicion of peripheral artery disease (PAD)
• History of cardiovascular disease
• Diabetic patients with symptoms of poor circulation

Preparation

• Fasting: No food or drink for 4-6 hours before the procedure.
• Medications: Some medications may need to be adjusted or stopped; consult your physician.
• Assessments: Blood tests, ECG, and possibly a renal function test to ensure it's safe to use contrast dye.

Procedure Description

1. Initial Scan without Contrast:

   • The patient lies on an MRI table which slides into a tube-like machine.
   • Initial images are taken using magnetic fields and radio waves.

2. Contrast Administration:

   • A contrast dye is injected intravenously.

3. Repeat Scan with Contrast:

   • A second set of images is taken to highlight the blood vessels more clearly.

4. Completion:

   • The procedure is non-invasive and typically painless.
   • The patient should remain still to ensure clear images.

Duration

The entire process generally takes about 60-90 minutes.

Setting

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

Personnel

• Radiologist: A doctor who specializes in imaging studies and interprets the images.
• MRI Technologist: Operates the MRI machine.
• Nurse or Technician: Assists with contrast dye administration and patient care.

Risks and Complications

Common Risks:

• Discomfort from lying still
• Mild allergic reaction to contrast dye

Rare Complications:

• Nephrogenic systemic fibrosis (a kidney-related condition)
• Severe allergic reactions to the contrast dye

Benefits

• Non-invasive with no radiation exposure.
• Precise images help in accurate diagnosis and treatment planning.
• Early detection of vascular conditions can prevent serious complications.

Recovery

• Post-Procedure: You can typically resume normal activities immediately.
• Instructions: Drink plenty of fluids to help flush out the contrast dye.
• Follow-Up: Your doctor will discuss the results with you and plan further action if needed.

Alternatives

• CT Angiography: Uses CT scan and contrast, involves radiation exposure.
• Doppler Ultrasound: Another non-invasive option but less detailed images.
• Conventional Angiography: Invasive with catheterization, higher risk but very detailed.

Patient Experience

During the scan, you'll need to lie still, and you might feel the MRI machine vibrate or hear loud noises. Post-contrast injection, you might feel a warming sensation. Discomfort is minimal, and pain management is usually not necessary.