Name of the Procedure:

Magnetic Resonance Angiography without Contrast followed by with Contrast, Pelvis (C8920)

Common Name(s): MRA of the Pelvis, MRI Angiography, Pelvic Magnetic Resonance Angiogram
Technical/Medical Term: Magnetic Resonance Angiography (MRA) of the Pelvis

Summary

Magnetic Resonance Angiography (MRA) of the pelvis is an imaging test that uses magnetic fields and radio waves to create detailed pictures of the blood vessels in the pelvic region. The procedure is done in two stages: first without a contrast dye and then with a contrast dye to provide enhanced images.

Purpose

This procedure is used to:

• Diagnose conditions affecting the blood vessels in the pelvis, such as aneurysms, blockages, or clots.
• Assess vascular anatomy before surgeries.
• Plan treatment for vascular conditions.

Indications

• Symptoms: Pelvic pain, leg pain, swelling, claudication (pain caused by too little blood flow).
• Conditions: Suspected vascular disease, arterial or venous malformations, prior to vascular surgeries.

Preparation

• Typically requires fasting for several hours before the procedure.
• Certain medications may need to be adjusted; instructions will be provided by the healthcare provider.
• Pre-procedure assessment may include a blood test to check kidney function and a review of any allergies, especially to contrast dye.

Procedure Description

1. The patient will be positioned on the MRI table.
2. Initial scans of the pelvic region will be taken without contrast dye.
3. The patient may be asked to hold their breath for short periods during scanning.
4. A contrast dye will be injected into a vein.
5. Additional scans will be taken to capture enhanced images of the blood vessels.
6. The procedure is non-invasive and typically takes about one hour.

Duration

The procedure usually lasts about 60-90 minutes.

Setting

Performed in a hospital radiology department, outpatient imaging center, or specialized MRI facility.

Personnel

• Radiologist: A doctor specialized in interpreting medical images.
• MRI Technologist: Operates the MRI machine and assists the patient.
• Nurse: May assist with intravenous contrast administration and patient care.

Risks and Complications

• Common: Minor discomfort or bruising at the injection site, allergic reaction to contrast dye.
• Rare: Kidney issues related to contrast dye, especially in patients with preexisting kidney conditions.

Benefits

• Provides detailed images of the pelvic blood vessels.
• Non-invasive with no exposure to ionizing radiation.
• Can help in accurate diagnosis and treatment planning.

Recovery

• Most patients can resume normal activities immediately after the procedure.
• Instructions may include drinking plenty of fluids to help flush the contrast dye from the body.
• Follow-up appointments may be scheduled to discuss the results.

Alternatives

• CT Angiography (CTA): Uses X-rays and contrast dye, involves radiation exposure.
• Doppler Ultrasound: Non-invasive, but may provide less detailed images compared to MRA.
• Conventional Angiography: Involves catheter insertion and exposure to X-rays, usually used if intervention is planned.

Patient Experience

During the procedure, patients may hear loud noises from the MRI machine and will be provided with earplugs or headphones. Some may feel claustrophobic inside the MRI scanner. Post-procedure, they may feel a bit of soreness or bruising at the injection site, but discomfort is usually minimal. Pain management and comfort measures, such as positioning aids and communication with the technologist, are typically available.