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Tsao TF, Cheng KL, Shen CY, Wu MC, Huang HH, Su CH, Chen FL, Tyan YS, Lin YC. Diagnostic Performance of Combined Contrast-Enhanced Magnetic Resonance Angiography and Phase-Contrast Magnetic Resonance Imaging in Suspected Subclavian Steal Syndrome. Can Assoc Radiol J 2016; 67:190-201. [PMID: 26831732 DOI: 10.1016/j.carj.2015.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 07/30/2015] [Accepted: 08/01/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The study sought to evaluate the efficacy of magnetic resonance imaging (MRI) in patients with suspected subclavian steal syndrome (SSS) using both contrast-enhanced (CE) MR angiography and phase-contrast (PC) MRI. METHODS Fifteen suspected SSSs from 13 patients were evaluated using CE-MR angiography and PC-MRI. Ten patients also received dynamic CE-MR angiography. RESULTS All MRI examinations were technically successful. By combining CE-MR angiography with PC-MRI, 10 SSSs were diagnosed in 9 patients. The delay enhancement dynamic technique predicted SSS with a sensitivity, specificity, and accuracy of 57.1%, 100%, and 72.7%, respectively. Without the dynamic technique, affected delay-enhanced arteries were poorly visualized and could be mistaken for occluded vessels. Retrograde vertebral flow by PC-MRI was used to predict ipsilateral SSS with a sensitivity, specificity, and accuracy of 100%, 60%, and 86.7%, respectively. There were 2 false positives including 1 patient with a proximal total occlusion of the affected vertebral artery and another with brachiocephalic steal syndrome rather than SSS. This suggested that retrograde vertebral flow does not always indicate SSS. CONCLUSIONS CE-MR angiography combined with PC-MRI is efficacious when evaluating SSS in clinical practice.
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Affiliation(s)
- Teng-Fu Tsao
- Department of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan, Republic of China; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China; School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan, Republic of China
| | - Kai-Lun Cheng
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China; School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan, Republic of China
| | - Chao-Yu Shen
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China; School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan, Republic of China
| | - Ming-Chi Wu
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China; School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan, Republic of China
| | - Hsin-Hui Huang
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China; School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan, Republic of China
| | - Chun-Hung Su
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China; Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Fong-Lin Chen
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China; Division of Pediatric Cardiology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Yeu-Sheng Tyan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China; School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan, Republic of China
| | - Yung-Chang Lin
- Department of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan, Republic of China; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China.
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