Conventional MRA provides inadequate visualization of the dynamic features of blood flow in vascular lesions of the head and neck. Four-dimensional time-resolved angiography using keyhole (4D-TRAK) is a new technique of performing contrast-enhanced MRA. By combining parallel imaging with sensitivity encoding (SENSE) with the keyhole imaging technique and a high field strength (3 T) magnet, we have been able to obtain detailed hemodynamic information similar to that obtained via catheter angiography with digital subtraction (DSA), but without the risks associated with ionizing radiation exposure, iodizing contrast agents, or catheterization itself.