(I MRA) In MR imaging, inflowing non-saturated fluid gives a higher signal intensity than stationary tissue. This effect makes it especially useful for imaging of flowing blood. Other factors such as susceptibility and spin saturation, can affect the signal of the blood within the vessels. Furthermore turbulence is part of normal blood flow and can decrease signal intensity.

See also Time of Flight Angiography.

(MRA) Magnetic resonance angiography is a medical imaging technique to visualize blood filled structures, including arteries, veins and the heart chambers. This MRI technique creates soft tissue contrast between blood vessels and surrounding tissues primarily created by flow, rather than displaying the vessel lumen. There are bright blood and black blood MRA techniques, named according to the appearance of the blood vessels. With this different MRA techniques both, the blood flow and the condition of the blood vessel walls can be seen. Flow effects in MRI can produce a range of artifacts. MRA takes advantage of these artifacts to create predictable image contrast due to the nature of flow.
Technical parameters of the MRA sequence greatly affect the sensitivity of the images to flow with different velocities or directions, turbulent flow and vessel size.
This are the three main types of MRA:
All angiographic techniques differentially enhance vascular MR signal. The names of the bright blood techniques TOF and PCA reflect the physical properties of flowing blood that were exploited to make the vessels appear bright. Contrast enhanced magnetic resonance angiography creates the angiographic effect by using an intravenously administered MR contrast agent to selectively shorten the T1 of blood and thereby cause the vessels to appear bright on T1 weighted images.
MRA images optimally display areas of constant blood flow-velocity, but there are many situations where the flow within a voxel has non-uniform speed or direction. In a diseased vessel these patterns are even more complex. Similar loss of streamline flow occurs at all vessel junctions and stenoses, and in regions of mural thrombosis. It results in a loss of signal, due to the loss of phase coherence between spins in the voxel.
This signal loss, usually only noticeable distal to a stenosis, used to be an obvious characteristic of MRA images. It is minimized by using small voxels and the shortest possible TE. Signal loss from disorganized flow is most noticeable in TOF imaging but also affects the PCA images.
Indications to perform a magnetic resonance angiography (MRA):
Conventional angiography or computerized tomography angiography (CT angiography) may be needed after MRA if a problem (such as an aneurysm) is present or if surgery is being considered.

See also Magnetic Resonance Imaging MRI.

(M2DMRA) The M2D technique can be used to image both fast and slow flow, due to good refreshment of flowing blood. Using overlapping slices can reduce staircase artifacts, which might be seen in projection of the slice thickness.

See also Time of Flight Angiography.

(MOTSA) This technique combines the best features of 2D time of flight angiography (2D TOF) and 3D TOF MRA. The MOTSA technique consists of multiple 2 cm thick 3D TOF slabs (which minimize saturation effects for through plane flow) combine to provide unlimited coverage similar to multiple 2D TOF slices. High resolution imaging of the carotid arteries is possible when image quality is of greater concern than acquisition time. Images with 1 mm (or less) spatial resolution in all three planes are required. The slabs typically overlap 25-40 to minimize the venetian blind artifact venetian blind artifact due to minimal saturation effects. MOTSA is an useful technique for the evaluation of vertebrobasilar ischemia and aneurysm scanning from the foramen magnum through the circle of Willis.

(PC) Phase contrast sequences are the basis of MRA techniques utilizing the change in the phase shifts of the flowing protons in the region of interest to create an image. Spins that are moving along the direction of a magnetic field gradient receive a phase shift proportional to their velocity.
In a phase contrast sequence two data sets with a different amount of flow sensitivity are acquired. This is usually accomplished by applying gradient pairs, which sequentially dephase and then rephase spins during the sequence. Both 2D and 3D acquisition techniques can be applied with phase contrast MRA.
The first data set is acquired with a flow compensated sequence, i. e. without flow sensitivity. The second data set is acquired with a flow sensitive sequence. The amount of flow sensitivity is controlled by the strength of the bipolar gradient pulse pair, which is incorporated into the sequence. Stationary tissue undergoes no effective phase change after the application of the two gradients. Caused by the different spatial localization of flowing blood to stationary tissue, it experiences a different size of the second bipolar gradient compared to the first. The result is a phase shift.
The raw data from the two data sets are subtracted. By comparing the phase of signals from each location in the two sequences the exact amount of motion induced phase change can be determined to have a map where pixel brightness is proportional to spatial velocity.
Phase contrast images represent the signal intensity of the velocity of spins at each point within the field of view. Regions that are stationary remain black while moving regions are represented as grey to white.
The phase shift is proportional to the spin's velocity, and this allows the quantitative assessment of flow velocities. The difference MRI signal has a maximum value for opposite directions. This velocity is typically referred to as venc, and depends on the pulse amplitude and distance between the gradient pulse pair. For velocities larger than venc the difference signal is decreased constantly until it gets zero. Therefore, in a phase contrast angiography it is important to correctly set the venc of the sequence to the maximum flow velocity which is expected during the measurement. High venc factors of the PC angiogram (more than 40 cm/sec) will selectively image the arteries (PCA - arteriography), whereas a venc factor of 20 cm/sec will perform the veins and sinuses (PCV or MRV - venography).

See also Flow Quantification, Contrast Enhanced MR Venography, Time of Flight Angiography, Time Resolved Imaging of Contrast Kinetics.