Tumour, Metastases Cranial nerve lesion, Cavernous angioma,( a cluster of abnormal blood vessels) Neurocysticercosis ( parasitic infection) Meningitis, Encephalitis, ( inflammation in brain) AVM, Infection Abscess Leukodystrophies

1. Brain Magnetic Resonance Angiography
Rukamanee Yadav
Assistant Professor
Department of
Paramedical and Allied
Health Science
Mewar University

2. Magnetic Resonance Imaging (MRA)
 It is a type of magnetic resonance imaging scan that
uses a magnetic field and MR pulse sequences to
determine the blood flow and image of vessels inside
the body.
 It is widely used in neurological disorder.
 It is less invasive procedure.
 Use non-ionizing radiation.

3. Types of MRA
 1-Time of flight MRA (TOF)
 2-Phase contrast MRA (PC)
 3-Contrast Enhanced MRA (CE)
 TOF-it is the technique to visualize flow within vessels,
without the contrast media inject.
 It is based on the phenomenon of flow related.
 No contrast injected.
 Difficulty with slow flow.
 This technique is time consuming compared to CE MRA.
 Advantage –used in renal failure.
 Used in allergic patient from gadolenium.

4. PC-MRA
 It is an MRI technique that can be used to visualized
moving fluid.
 It is used for MRI venography, no IV contrast
requiring.
 Allow quantification of blood flow and velocity.
 More time consuming.

5. CE- MRA
 It is best method because of its accuracy.
 Gadolinium contrast media is used .
 Gd reduce the T1 relaxation time.
 Data are acquired after contrast media injected.
 0.1-0.2 mmol/kg.
 20 ml contrast media injected at 1 ml/sec.
 This technique is less flow sensitive.
 It can be performed within seconds.
 Nephrogenic systemic fibrosis( thickening of skin and
subcutaneous tissue) is rare but serious complication.
 Advantage-batter spatial resolution
 Less time required.
 No susceptibility artifacts.

6. Advantages-
 Compared with catheter angiography, MRA is less
invasive Procedure.
 Less expansive and faster procedure perform.
 For conventional angiography, catheter is inserted
through the patient groin and threaded up into the
artery .
 MRA does not require this catheter.
 As a result , is eliminates related complications such
as possible damage to an artery.

7. Indications for brain MRA
 Tumour,
 Metastases
 Cranial nerve lesion,
 Cavernous angioma,( a cluster of abnormal blood vessels)
 Neurocysticercosis ( parasitic infection)
 Meningitis,
 Encephalitis, ( inflammation in brain)
 AVM, Infection Abscess
 Leukodystrophies( abnormal growth of white matter in the
brain)
 Syringomyelia- neurological pathology ( fluid filled cyst form
within the spinal cord)

8. contraindications
 Any magnetically activated implant e.g.-cardiac
pacemaker,
 Insulin pump,
 cochlear implant and hearing aids.
 Aneurysm clips (except titanium)
 Metallic foreign body in eye.
 Pregnancy.( first trimester)

9. Patient preparation
 Remove all metallic ornaments.
 Wear hospital gown.
 Fasting 4-6 hours.
 Explain the procedure and give the instruction before perform
the procedure.
 Take the written consent.
 If possible provide attendent for claustrophobic patients (e.g.
relative or staff )
 Contrast injection risk and benefits must be explained to the
patient before the scan.
 Gadolinium should only be given to the patient if GFR is > 30
 Offer earplugs or headphones, possibly with music for extra
comfort.

10. Patient Position
 Head first supine
 Position the head in the head coil and immobilise
with cushions
 Give cushions under the legs for extra comfort
 Centre the laser beam localiser over the glabella
 Topogram:
 Center the FOV on the nasion in the midline.
 Axial sequence- plot on sagittal plane.
 Parallel to line the genu and splenium of carpus
callosum.

11. Conti…

12. Intracranial Aneurysm

13. Conti..

14. Thank you.