title: Diagnostic Performance of Combined Contrast-Enhanced Magnetic Resonance Angiography and Phase-Contrast Magnetic Resonance Imaging in Suspected Subclavian Steal Syndrome.
abstract: OBJECTIVE
  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.
authors.affiliation: 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.
authors.forename: Teng-Fu
authors.initials: TF
authors.lastname: Tsao
authors.affiliation: 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.
authors.forename: Kai-Lun
authors.initials: KL
authors.lastname: Cheng
authors.affiliation: 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.
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Shen
authors.affiliation: 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.
authors.forename: Ming-Chi
authors.initials: MC
authors.lastname: Wu
authors.affiliation: 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.
authors.forename: Hsin-Hui
authors.initials: HH
authors.lastname: Huang
authors.affiliation: 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.
authors.forename: Chun-Hung
authors.initials: CH
authors.lastname: Su
authors.affiliation: 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.
authors.forename: Fong-Lin
authors.initials: FL
authors.lastname: Chen
authors.affiliation: 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.
authors.forename: Yeu-Sheng
authors.initials: YS
authors.lastname: Tyan
authors.affiliation: 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. Electronic address: cshy1069@csh.org.tw.
authors.forename: Yung-Chang
authors.initials: YC
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013349:Subclavian Steal Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Brachiocephalic steal syndrome; Magnetic resonance angiography; Phase-contrast imaging; Subclavian steal syndrome