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Normal MRA Brain Report Template (3D Time-of-Flight)
Normal brain MRA report template: 3D time-of-flight circle of Willis wording with vessel-by-vessel patency, plus flow-artifact and small-aneurysm notes.
EXAMINATION: MR angiogram of the brain without intravenous contrast. CLINICAL HISTORY: [indication] COMPARISON: None available. TECHNIQUE: 3D time-of-flight MR angiography of the intracranial arteries with maximum-intensity-projection and multiplanar reformats, without intravenous contrast. FINDINGS: Internal carotid arteries: The cavernous and supraclinoid segments are patent bilaterally, with normal flow-related enhancement. No stenosis or aneurysm. Anterior circulation: The A1 and A2 segments of the anterior cerebral arteries and the M1 and M2 segments of the middle cerebral arteries are patent bilaterally. No occlusion, flow-limiting stenosis or aneurysm. Posterior circulation: The intracranial vertebral arteries, basilar artery and P1 and P2 segments of the posterior cerebral arteries are patent. No stenosis, occlusion or aneurysm. Circle of Willis: Patent, with conventional configuration. Anterior and posterior communicating arteries: [Visualized/not visualized]; nonvisualization is a common normal variant on time-of-flight imaging. IMPRESSION: 1. No intracranial aneurysm, flow-limiting stenosis or occlusion identified.
Dictation notes
- Time-of-flight shows flow, not lumen — slow or in-plane flow mimics stenosis, so confirm any apparent narrowing on the source images before it reaches the impression.
- Sensitivity falls off below about 3 mm — when the indication is aneurysm screening, the impression should say small aneurysms below the resolution of the technique are not excluded.
- T1-hyperintense thrombus or methemoglobin can masquerade as flow on the MIPs — a “patent” vessel on the reformat still needs a look at the source and conventional sequences.
Related references
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