Abstract
Contrast enhanced magnetic resonance angiography (MRA) with gadolinium containing contrast media has evolved to a standard non-invasive imaging modality. High quality 3D vessel reconstructions can be acquired using conventional MR scanners together with body surface coils and 3D gradient sequences. The predominant indications for MRAs lie in the diagnostics, planning of vascular interventions and surgery of patients suffering from peripheral artery disease. With high sensitivity and specificity clinically relevant stenoses can be detected and collateral vessels identified. Methodological limitations mainly lie in the imaging of small and peripheral arteries and stented segments. The most important contraindications comprise conventional cardiac pacemakers, implantable defibrillators, paramagnetic implants, and 1st trimester pregnancy. Furthermore, in patients with severe renal failure (glomerular filtration rate of less than 30 ml/min/1.73 m2) gadolinium containing contrast medium should not be used as these patients are at increased risk of development of nephrogenic systemic fibrosis for which no treatment exists. Novel contrast free MRA techniques (e.g. QISS) have been developed and are currently under clinical validation but are not yet widely available.