The Clinical Value of Non-Contrast-Enhanced MRA
Ruth P Lim1,2
1Austin Health, Melbourne, Australia, 2Department of Radiology and Surgery, The University of Melbourne, Melbourne, Australia

Synopsis

Keywords: Cardiovascular: Vascular, Cardiovascular: Angiography

Non contrast enhanced MRA (NC MRA) has been available for many years with multiple techniques developed in response to the discovery of Nephrogenic Systemic Fibrosis. When to consider NC MRA will be discussed, including advantages and challenges. Techniques including flow-dependent, flow independent and phase sensitive techniques will be reviewed, as well as where within the body they are best applied. Clinical examples applying these techniques will be discussed.

When should we consider NC MRA techniques?

  • When contrast agent administration is undesirable including a review of current international guidelines for gadolinium contrast administration, e.g. acute kidney injury, allergy, during pregnancy, IV access unable to be obtained, long term follow-up with regular repeat examinations.
  • When NC MRA might be preferable, e.g. intracranial imaging, paediatric imaging (e.g. Kawasaki disease)

What techniques are available?

  • The review will focus upon commercially available techniques available for clinical practice, with a brief overview of each technique, tips and challenges to be aware of.
  • Flow independent imaging: bSSFP MRA
  • Flow dependent imaging: a) non-subtractive - time of flight MRA, inflow inversion recovery imaging, quiescent interval single shot imaging; b) subtractive - ASL, fast spin echo MRAPhase dependent imaging
  • Phase contrast MRA (3D, 4D flow)

Clinical Scenarios

A range of clinical scenarios displaying applications of NC MRA techniques and evidence for their use will be shown. Time permitting future directions will be discussed.

Acknowledgements

No acknowledgement found.

References

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Proc. Intl. Soc. Mag. Reson. Med. 31 (2023)