MRA for Aneurysm (Post Coil/Stent)
Basics: What is an MRA Head, Aneurysm Post Coil/Stent?
The term “MRA” stands for “magnetic resonance angiography.” It’s an MRI exam, which is designed to just look at the arteries in your head, not the brain tissue itself. It works by using some tricks based on the fact that the blood is moving quickly through the head, while the brain tissue does not move. In short, MRA of the head is a relatively quick (20 minutes), extremely accurate noninvasive test to get a close look at the arteries in your head. It is extremely good at finding narrowed arteries (stenosis), brain aneurysms, fistulas, and arterovenous malformations, with stenosis and aneurysms of the intracranial arteries being more common blood vessel pathologies in the head which can be fixed, otherwise leading to potentially devastating strokes and/or death.
“MRA Head, Aneurysm Post Coil/Stent” is a slightly more involved study. In addition to performing a standard MRA Head, a second, different type of MRA is also obtained, using MRI contrast (gadolinium). This is because the metal in the coils and or stents, can potentially distort the picture on standard MRA, and hide any residual abnormality after the aneurysm has been treated. Contrast MRA minimizes this distortion, and increases the sensitivity of the study. This allows patients with brain aneurysms that have been treated with coils and or stents, to be followed noninvasively.
Answers to commonly asked questions about MRA Head, Aneurysm Post Coil/Stent:
Q: Do you have to put an IV in to inject dye?
Q: What is the typical imaging workup, and follow up for a brain aneurysm after treatment?
The initial imaging study is usually MRA or CTA (CT angiography).
Next the patient is treated/embolized using 3D biplane angiography.
Within the next week, the patient gets a baseline MRA of the head with and without contrast.
Next the patient is followed up typically at 3 months (ruptured aneurysm), to 6 months
(unruptured aneurysm). This is individualized to each patient.
Next, the patient is followed up at varying intervals. At our institution, we follow the aneurysm with an MRA annually, for 2 years, then every other year.
Discussion of images above:
Patients with brain aneurysms who have had them treated through an endovascular procedure called coiling and/or stenting, often require follow up scanning to view the coils and/or stents. This MRA scan combines a regular MRA with contrast dye, which is injected into a vein through an IV. The contrast moves through the arteries in the brain, lighting up the arteries with contrast dye. The images above, (an MRA Head, Aneurysm Post Coil/Stent) demonstrates an aneurysm previously treated/coiled, with some residual aneurysm at the anterior communicating artery region.