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Knowledge of MRA test after MRI? / Joining

Hi. I'm new here... I won't write a long story, but briefly, I've been having MS symptoms for 7 years, or 3 years (depending on how you look at it). I had a dropped foot 7 years ago, then nothing until 3 years ago when almost all of the symptoms started showing up -- all getting worse now with no reprieve. First MRI only showed a venous angioma. I keep falling, and I just had a second MRI. My new neurologist just ordered an MRA and I wonder what he is looking for... I was told by the nurse that there is a spot on my thalamus that needs further investigation. From what I've seen on the internet, an MRA doesn't look like something that would determine a lesion. If anyone knows anything about this, I'd sure appreciate hearing from you. The internet articles are too complicated, and cognnitive loss is one of my symptoms... Also, I,d like to join this community, but don't see the green button by the forum's name. Thank you so much.
Best Answer
3054080 tn?1358722856
I did some digging and found this information. I am thinking that they use the MRI machine but in a different way than for MRI with and without contrast. Lol, I am so sorry if I have completely confused you :)

A magnetic resonance angiogram (MRA) is a type of magnetic resonance imaging (MRI) scan that uses a magnetic field and pulses of radio wave energy to provide pictures of blood vessels inside the body. The radiologist may talk to you about the results of your MRA right after the test. Complete results are usually available for your doctor in 1 to 2 days.

Magnetic resonance angiogram (MRA)

Normal: The blood vessels look normal and the blood flow through them is not reduced or stopped. No blood clots or large plaque buildup is seen.

Blood vessel walls are normal. No bleeding, abnormal collections of fluid, blockage in the flow of blood, or bulges in the blood vessels (aneurysms) are present.

Abnormal: Partial or complete blockage of a blood vessel may be seen. Blockage may be caused by a blood clot, the buildup of fat and calcium deposits (plaque), or narrowing (stenosis) of the blood vessel.

A bulge (aneurysm) in the blood vessel wall may be seen. Damage to the wall of a blood vessel may be seen.

Conventional angiogram or a CT angiogram (computed tomography angiogram) may be needed after MRA if a problem, such as an aneurysm, is found or if surgery may be needed.
17 Responses
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Avatar universal
My MRI showed CVa so my neuronist order a mra
Helpful - 0
382218 tn?1341181487
The procedure for requesting a CD no doubt varies widely, and is dependent upon the facility.  At mine, a CD is provided to the patient free of charge when the referring physician includes instruction to provide a copy of it to the patient.  No reason is needed and the patient isn't required to fill out or sign any documents.  For that reason it's probably a good idea to inquire with the facility in advance to understand their particular procedure.
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1045086 tn?1332126422
Excellent info to share about the CD Kristin!  It kind of makes sense that they charge for personal use but not for other health care related use.  Kind of….  Anyway, I’m glad they guided you in how to choose and you’ll have the CD for your records.  I either forgot about those boxes or never realized they were there.  Each possibility is equally probable.
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Avatar universal
Hey, Kyle. 21 years before a diagnosis. Wow... I know you said the feeling came back, but... wow. You know, at the time of my foot drop (and it was a COMPLETE drop), no one ever questioned WHY I had it. They just did the electrical testing, etc., right on the lower leg, had me fit with a prosthesis and crutches, and sent me to therapy. I didn't know enough to be concerned beyond that... Crazy, huh? I got most of my range of motion back, but to this day the leg is atrophied.

I hope you are doing well, and having a good day.

Peace,
Kristin
Helpful - 0
Avatar universal
Hi, again! Just back from my MRA and I wanted you to know that I requested not only a CD copy of THIS test, but also of the MRI done a couple of weeks ago, based on your advice. I didn't walk out with it, but only because I requested that previous test, too.

You might have mentioned this in your post, but when one requests a CD copy like this, you have to sign a form stating what it is for. If you check "personal" you'll probably be charged, I was told. I checked "continuing care" and "SSDI."

Thank you for the advice, again! And I hope you have a good day.

Peace,
Kristin

Helpful - 0
1045086 tn?1332126422
You don't have to take a CD for them to use.  The place that does the MRI/MRA will provide one.  Some places put them in a fancy envelope with labels even.  Just let them know you want it when you sign in so they can plan to do it.

It isn't at all unusual to start with brain scans only.  These are expensive tests that take considerable time in the machine.  The brain is the most likely place for a problem to show up.  They will image the spine later if that is needed.

A diagnosis sometimes helps with a disability claim approval but a diagnosis is not required.  Disability is granted based on the anticipation that a person will be unable to adequately perform an income producing job for an extended period of time.  You do need physician documentation of disability and a degree of the doc's cooperation in the process.

I know it is hard but you just have to do what you can for each day and try not to allow the process to consume your entire existence.  Having a doctor interested in finding out what is going on should be very helpful.  You would expect that to be a common thing but it doesn’t seem to be.  
Helpful - 0
1831849 tn?1383228392
""They don't know what caused the dropped foot years ago""

I was diagnosed a year ago. 21 years ago I lost feeling in my feet. They couldn't figure it out and the feeling came back. My current MS Doc says that was absolutely my first relapse.

Kyle
Helpful - 0
Avatar universal
Hi, twopack. The kind responses of everyone here, and the time taken to help me are so appreciated. THANK YOU for the CD advice -- I will most definately do that. do I just bring a regular old "Best Buy" kind of CD that can't be recorded over? A CD for each scan separately?

Both my MRIs were done with contrast. The first, over a year ago (I think) was head and neck. That doctor was awful and totally dismissed me. He told me I was too old to be diagnosed with MS. Now we have moved to Eau Claire, and I am in a Mayo system Clinic, and this doctor (whom I've only seen once) took me seriously... but then he only ordered the head MRI. I am guessing it will be only a head MRA as well. They all want to call it migraines and anxiety. Funny -- I DO have migraines (and a ton of anxiety!)... but I just don't see how that could cause a formerly bright woman to not be able to remember her address or to collapse for no reason multiple times or to walk unsteadily, etc...

I did figure out now that I'm a member of the forum now, and I dearly appreciate all the responses. You all have been moe supportive than my loved ones.  Thank you, again.
Helpful - 0
Avatar universal
Thank you, Kyle. It IS confusing, but I didn't even know what PPMS was, so I went and looked that up and that helped. I can't sort out what's wrong with me, but those are the symptoms. I think, though, that you are saying PPMS would need to show many lesions. I don't understand why the neurologists are only doing head scans when there could be spinal lesions. They must suspect something else... When I looked up PPMS, it also had a lot of diagnostic criteria (which I'm sure is true for any neurological disorder) -- and I can't remember what might be a remission or an attack... They don't know what caused the dropped foot years ago, and I don't even know if that is being considered in the equation. The SSDI looks as though it will be very hard to prove, until I'm in very very serious condition. Thanks again for giving me more basics to look into...
Helpful - 0
1045086 tn?1332126422
Hope this still helps.

An MRI gives detailed views of organs and tissues.
An MRA gives detailed views of blood vessels.
Both can be done with and without contrast.
Both exams are done on the same machine.

Have you already had both tests?
In case you aren't aware, you can request to have the images stored on a CD to take with you.  It only takes a few minutes for the radiology tech to do that.  You should be able to have the CD in hand before you leave.  

The benefit in having the CD is to take it to your neuro and ask him/her to review them and explain what is seen OR to share with another neuro if you ever need another opinion.  

I have a MRI from 1990 on CD that was useful when my MS diagnosis was confirmed in 2010.  It revealed much more than the report alone.  

Also, get records of each visit as you go and organize your own personnel health file.  It will likely be more complete than any an individual doctor has.  Most offices don't put up much fuss these days.  Health care facilities aren't required to keep record available forever.  When they have what you want they often charge for copies.  The MRI CDs I've gotten have always been free.

Most important!  Please keep pushing for a doctor who won’t be satisfied until there is a clear reason WHY you are losing physical and cognitive function.  None of us should be robbed of living the life we desire without an explanation we can understand and believe.

--------------------
Next question:

Posting a question here (or with any MedHelp forum or group) should automatically make you a member of that forum.  If it doesn't show up like that on your own profile page do this:

Click on the name of one of the members who responded here.  
That will take you to that person's profile page.
Once there, find a list of the forums that person has joined.  
Locate the one that says 'Multiple Sclerosis'.
Click on the word 'Join' (to the right of the community name).  
Done.  Sorry it isn't easier than that :(

If none of the above works give a shout here or send me a message.  I'll try to find out where the glitch is.

If you should ever want to remove yourself from a forum membership you go to your own profile and click the word 'Leave' next to the forum you no longer which to participate in.  However, in this community we general believe in the 'Once-a-Member, Always-a-Member' philosophy.
Helpful - 0
1831849 tn?1383228392
For other than PPMS, I think you can be diagnosed with as few as two lesions. They need to be in different parts of the brain, or one in the c-spine and one in the brain, and they need to be of different vintages. This could mean a second lesion appears on a follow up scan or you have one enhancing and one non-enhancing lesion on the same scan.

Not that interpreting these criteria is confusing :-)

Kyle
Helpful - 0
Avatar universal
Thanks for the information. I believe there is only one spot, and at least 3 are needed for dx of MS... My MRIs didn't show that. Still, I have almost every classic symptom in the book, so I just don't know what to think. At this point, I just want a diagnosis... My symptoms are erratic, and family and husband don't always see them, and I'm not getting a ton of personal support... I chose to retire from teaching because I couldn't think right anymore (that is scarier than the falling, neuropathy, tremors, etc.) and I looked drunk sometimes. So now I am going through an SSDI appeal, and the whole thing has just been... too much for too long. Your answer helped in that I don't think this test is used for MS screening... I wish you a ton of luck and best wishes.  Kristin
Helpful - 0
Avatar universal
Thanks, LilMinnie! I have looked and looked and don't understand everything, but I understand your response. Both of my MRIs were done with contrast, so the MRA is different from that for sure. From what you and the other person said, though, they are probably not looking for a lesion... The nurse who scheduled it told me very little about the "spot," so I don't even know how big it is. They wanted me in the next day for this procedure, but I am out of town with my Mother who is having surgery. I can't go for the test until Monday -- but you are also correct that the results are read quickly, and they scheduled the conference with the doctor for the next day. The urgency was a little scary to me... I have been told I cannot drive because of the symptoms, or I could have gotten there and back to my Mom if it weren't for that... If I have mine before yours, I'll give you an update. Thanks so much for all the time and effort you put into replying to me -- it helped.  Kristin
Helpful - 0
382218 tn?1341181487
I had a MRA as a result of an apparent abnormality of a blood vessel that showed up on my brain MRI.  LilMinnie is correct, the test is done in a regular MRI machine.  They were concerned about a possible aneurysm.  The MRA provided a clearer picture of the blood vessels which were fine.  The MRI that had preceded it was the one that resulted in my MS dx.
Helpful - 0
3054080 tn?1358722856
Well, I am a bit confused. From what I found, it sounds like it is an MRI with contrast. The MRA test is performed in an MRI machine. Hmmm. I thought MRI with and without contrast were different types of MRI and the MRA was a different type of test! Boy, I have a lot to learn :( I hope someone with more knowledge will chime in here!

Hugs,

Minnie :)
Helpful - 0
3054080 tn?1358722856
Hi, I am going through the diagnostic process too. I have been ordered an MRI with and without contrast with an MRA contingent on the results of the MRI. I have not researched the MRA so I am not sure what it is for either. If I get a chance I'll see what I can find out. A friend did tell me she had one to check for anyrysm (sp) or bleeding in the brain, but there again, that is hearsay :)

Best of luck,

Minnie :)
Helpful - 0
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