Magnetic Resonance Angiography

in Vascular Diagnostics and Imaging

Applied

Type

Modification

Confidence

90%

Created

Apr 19, 2026

Evidence

1 source

Rationale

The 2024 ACC/AHA Lower Extremity PAD Guideline (PMID 38743805) directly supersedes the 2016 AHA guideline for the recommendation that MRA is an alternative first-line imaging modality when CTA is contraindicated. Per the stale guideline replacement instructions, Patel MR, et al is replaced with AHA in the Guidelines bullet, as both citations support the same claim and the newer guideline is the authoritative current reference. No other content changes are warranted, as the remaining citations address distinct topics (aortic pathology, European guidelines, etc.) that are not superseded by this article.

Evidence

AHA. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024. PMID: 38743805. DOI: 10.1161/CIR.0000000000001251.
Verified source
PubMedDOI

Content Changes

* **Advantages:** No ionizing radiation and excellent soft tissue contrast.
* **Techniques:** Time-of-flight (TOF), contrast-enhanced magnetic resonance angiography (MRA) (CE-MRA), and non-contrast MRA options for patients with renal insufficiency or contrast allergy. Vessel-wall imaging sequences provide enhanced characterization of vasculitis and arterial dissection.
* **Applications:**
  * Carotid and intracranial disease.
  * Aortic pathology, particularly in connective tissue disorders [@aha2022-b] [@aha2023].
  * Renal artery stenosis.
  * Lower extremity peripheral artery disease (PAD) mapping when computed tomography angiography (CTA) is unsuitable [@svs2024-c].
* **Limitations:** Limited availability, higher cost, and contraindications including certain metallic implants, pacemakers, and claustrophobia.
* **Guidelines:** Recommended as alternative first-line imaging when CTA is contraindicated; modality choice should be guided by specific disease characteristics and patient factors. [@prince2016] [@aha2016][@svs2024-gornik] [@esc2017] [@esvs2018-esvs] [@esvs2019-aaa] [@aha2022-b] [@svs2024-c]
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