About an MR angiogram of the spine
An MR angiogram (MRA) is a type of MRI scan that focuses on blood vessels. It uses a strong magnetic field, radio waves and a computer to make detailed pictures without X-rays, and without passing a tube (catheter) into an artery.
A spinal MRA looks at the small arteries and veins that supply the spinal cord. It is usually requested when an MRI of the spine has shown swelling of the spinal cord or enlarged veins on its surface, which can be a sign of an abnormal connection between an artery and a vein. The most common of these is a spinal dural arteriovenous fistula (SDAVF), where blood flows directly from an artery into a vein near a nerve root. The vein becomes congested, which can cause swelling of the spinal cord and gradually affect how the nerves work.
Time-resolved MRA, which takes a rapid series of pictures as contrast dye flows through the vessels, can help show where a fistula is and which vessels feed it. This can help your specialist plan further tests or treatment, and in some cases it can make a catheter angiogram shorter and more targeted. A catheter angiogram is still usually needed to confirm the exact level before treatment.
Referral needed: this scan requires a referral from a specialist, such as a neurologist, neurosurgeon, vascular surgeon or other hospital consultant. You can upload the referral when you book.
What happens during the scan
You lie on your back on the scanner bed with a coil placed under your back. The scanner is loud, so you will wear ear plugs or headphones, and the radiographer can see, hear and talk to you throughout. You will need to keep your back very still, as even small movements can blur the pictures of the blood vessels.
Most MR angiograms use an injection of contrast dye (gadolinium) through a small cannula in a vein, usually in your arm or hand, so the blood vessels show up clearly. Gadolinium is less likely to cause an allergic reaction than the iodine-based dye used for CT. Some vessels can also be imaged without contrast. If you have contrast, you may be asked to wait for up to 30 minutes afterwards. Where contrast is needed, it is charged separately.
What the scan can show
A spinal MR angiogram can help to look at:
- spinal dural arteriovenous fistulas (SDAVF)
- other abnormal tangles or connections of blood vessels in or around the spinal cord (arteriovenous malformations)
- the arteries that feed, and the veins that drain, an abnormal connection
- the likely level of the spine involved, to guide further tests or treatment
- blood vessels after treatment, to check that an abnormal connection has closed
Very small spinal vessels can be hard to see on MRA, so your specialist will consider the results alongside your symptoms and other scans.
Preparing for your scan
No special preparation is usually needed. Because spinal MR angiograms use contrast dye, let us know when you book if you have kidney problems or have had a reaction to contrast before. If you have had a previous spine MRI, upload the report when you book so it can be compared.
You can usually eat, drink and take your normal medicines unless the scanning centre tells you otherwise. Wear loose, comfortable clothing without metal zips or buttons, and leave jewellery at home. You will be asked to remove metal items such as hair clips, hearing aids, coins and keys, and you may be asked to change into a gown.
Before the scan you will complete a safety questionnaire. Tell the team if you have a pacemaker, any metal implant, surgical clips or other device, if you have kidney problems or allergies, or if you are, or might be, pregnant or breastfeeding. If you feel anxious in enclosed spaces, let us know when you book. Some centres can offer a relaxant, and if you take one you will need someone to take you home and must not drive for 24 hours.
Frequently asked questions
Do I need a referral for an MR angiogram of the spine?
Yes. This scan requires a referral from a specialist. Please upload your referral when you book so the scanning centre can check that the right scan is arranged.
What is a spinal dural arteriovenous fistula?
It is an abnormal connection between an artery and a vein near a nerve root in the spine. Blood flowing straight from the artery into the vein causes the veins around the spinal cord to become congested, which can lead to swelling of the cord and problems with nerve function. An MR angiogram can help find it.
How is an MR angiogram different from a normal angiogram?
A traditional (catheter) angiogram involves passing a thin tube into an artery, usually from the groin or wrist, and uses X-rays. An MR angiogram uses an MRI scanner, with at most an injection into a vein in your arm, so there is no catheter and no radiation.
Will I need a contrast injection?
Yes, spinal MR angiograms normally use contrast dye to show how blood flows through the vessels. It is given through a small cannula in your arm and is charged separately.
Sources
- Diagnostic accuracy of 4D-MRA for the detection and localization of spinal dural arteriovenous fistulas (Brain & Spine, 2024)
- American Journal of Neuroradiology – Contrast-enhanced MR angiography of spinal dural arteriovenous fistulas
- RadiologyInfo.org – Magnetic Resonance Angiography (MRA)
- NHS – MRI scan
The information on this page has been gathered from various sources and is provided for general information only. It is not medical advice. TOP MRI is not liable for the accuracy or completeness of this information. Please speak to your doctor or the scanning centre about your own situation.