MRA Neck Dr. Mohamed Samieh

MR Angiography Angiography is a medical test that helps physicians diagnose and treat medical conditions related to blood vessels.

MR Angiography Neck MRA stands for Magnetic Resonance Angiography. It is an MRI technique that specifically evaluates vessels such as arteries. Carotid MRA evaluate the vessels of the neck

Carotid MRA are typically ordered for the evaluation of stroke to detect blockages and narrowing of the arteries in the neck that ultimately supply the brain.  Symptoms related to stroke include: weakness sudden speech difficulties confusion, erratic behavior vertigo, dizziness pain, tingling numbness

Carotid MRA can diagnose: Dissection - This refers to a tear in the wall of the vessel. Aneurysms and Vascular Tumors - Aneurysms are ballooning of the vessels

MRA of the carotids will evaluate: Internal Carotid Arteries The carotid vessels arise from the aorta. Vereberal and Basilar Arteries The basilar artery is made up by two vertebral arteries

Aortic Arch This is the large vessel which arises from heart. Parts of the soft tissues of the neck are seen in a Carotid MRA.

MRA Neck Indications Aneurysms and vascular tumors. narrowing and blockage of the vessels of the neck. Arterio -venous malformation Stroke. Internal Carotid Artery Occlusion. Injury in the carotid artery.

MRA Neck contraindications An implanted electronic device, such as a 1 - pacemaker 2- Metallic aneurysm clips, certain artificial 3 - heart valves and metallic hearing implants 4 - Certain vascular stents and certain metal 5 – patient with unstable neurology (make exam under anesthesia)

Patient Preparation 1- Have the patient go to toilet 2- Explain the procedure to patient 3- Offer the patient ear protectors 4- Ask the [patient to remove any thing containing metal

Position of MRA Neck Head first supine Position the Neck in the Neck coil and immobilise with cushions Give cushions under the legs for extra comfort Centre the laser beam localiser at the line present on the coli

Suggested protocols , parameters and planning A three plane must be taken in the beginning to localise and plan the sequences. Localizers are normally less than 25sec. axial sagittal coronal TR TE NEK thickness FOV GAP SLABs 102 3 1 5 29 X 29 10 % No Slab

T2 FSE Axial Neck Plan the axial slices on the sagittal and coronal plane axial slices is parallel to intervertebral disk. Slices must be sufficient to cover area from the midbrain to the arch of aorta . Check the positioning block in the other two planes . TR TE NEK thickness FOV Freq DIR GAP SLABs 3700 90 4 7.5 26 x 20 R > L 10 % anterior and inferior

TOF” relates to time of flight 2D TOF TOF” relates to time of flight Time of flight angiography (TOF) is an MRI technique to visualize flow within vessels, without the need to administer contrast. With 2-D TOF, multiple thin imaging slices. TR TE NEK thickness FOV MATREIX Freq DIR GAP SLABs 32 - 40 5-9 2 1 24 x 18 256x256 A > P 10 % no

Example From Image Produce From 2D TOF

IVI image (Reformat ) to produce angio images