Abstract

TRICKS MRA

Dr. Asha M.L, *Dr. Aprajita Dua, Dr. Chaitanya Reddy, Dr. Lekshmy.J, Dr. Basetty Neelakantam Rajarathnam and Dr. Mahesh Kumar H.

Abstract

Head–neck vascular anomalies (HNVAs) are congenital aberrancies of vascular development; clinical appearance of which depends on their depth and phase of growth. The diagnosis of haemangiomas or vascular malformations is most often a clinical one; imaging plays a pivotal role in the diagnosis of more challenging cases and in planning the therapeutic approach that may consist of pharmacological embolization, sclerotherapy or surgery. Doppler ultrasonography is the first imaging modality used to characterize maxillofacial superficial lesions and their haemodynamic conditions; but Doppler ultrasonography is not able to depict the real extension and, most importantly, the vascular anatomy of complex HNVAs. Contrast CT may provide further information by identifying calcifications and in demonstrating involvement of major vessels after contrast injection,but they use considerable X-ray dosages (avoidable especially in young patients). MRI and MR angiography (MRA) represent the best diagnostic tools to demonstrate, respectively, soft-tissue components and relationships with nearby structures and to provide useful information on HNVA feeding vessels. Time-resolved imaging of contrast kinetics (TRICKS) is a recently introduced keyhole technique that improves temporal resolution with respect to contrast-enhanced MRA technique; by this, one can obtain dynamic images during the arterial, capillary and venous phases. This review provides an insight into this technique.

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