MRA of the chest may be considered medically necessary in patients with the following indications in whom angiography/venography would otherwise be indicated and in whom the result of MRA could obviate the need for angiography/venography:
Acquired disease of the thoracic aorta (i.e., aortic dissection, aneurysm occlusive disease, and aortitis);
· Developmental anomaly of the thoracic vasculature; or
· Systemic venous thrombosis or occlusion.
MRA of the chest may be considered medically necessary as an alternative to angiography for evaluation of pulmonary embolus in patients who have a contraindication to the use of IV iodinated contrast material (e.g., a history of severe contrast media allergy, such as anaphylactic shock or a cardiac arrest; or high risk of contrast-induced renal failure such as in diabetic patients with moderate renal insufficiency).
Investigational applications of MRA of the chest include, but are not limited to, the following:
· Evaluation of pulmonary emboli in patients without contraindications to the use of IV iodinated contrast agents.
