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Magnetic Resonance Angiography: Vascular and Flow Imaging

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Title: Magnetic Resonance Angiography: Vascular and Flow Imaging.

Agency: Agency for Health Care Policy and Research/Center for Health Care Technology (Formerly, the Office of Health Technology Assessment).

Contact: Harry Handelsman, D.O., Medical Officer Thomas V. Holohan, M.D., Director, CHCT.

Status: Technology Assessment: Published, 1994.

Language: English.

Primary Objective: Scientific evaluation of the clinical effectiveness of MRA for the Health Care Financing Administration's Medicare coverage policy.

Methods Used: Synthesis of published literature, information solicited from professional societies and organizations with interest or experience with this technology, and consultation with U.S. Public Health Service (NIH and FDA).

Data Identification: English language journal articles and textbooks published between 1985 and August 1993 available through the search capabilities of the National Library of Medicine. Key words: "MRI Angiography" and "MRA."

Study Selection: 46 studies involving 5 or more patients comparing results of MRA with conventional angiography. Bibliography: 171 citations relating to the history, basic principles, and clinical applications of MRA.

Data Extraction: Percentage agreement and accuracy of MRA vs. conventional angiography in the areas of the head and neck, abdomen, thorax, and peripheral vascular system.

Key Results/Findings: MRA techniques can provide anatomic images of blood vessels which can be projected in a format similar to that of conventional angiography and also provide physiologic information. MRA has, in many patients, demonstrated diagnostic accuracy comparable to that of conventional angiography. However, conventional angiography continues to be regarded as the standard technique for routine imaging by the majority of clinicians. Limited available data indicate MRA to be less costly than conventional angiography, especially if performed in outpatient facilities.

Conclusions/Options: On the basis of a growing clinical experience demonstrating the clinical usefulness of MRA comparable to that of other imaging techniques, MRA appears to be a promising technology for replacing competing invasive and noninvasive imaging methods in a variety of clinical situations.

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