Velocity-Encoded Phase-Contrast Magnetic Resonance Imaging for Diagnosing Severe Bilateral Subclavian Steal Syndrome with Complete Vertebral Reversal.
Subclavian steal syndrome (SSS) involves changes in hemodynamics secondary to proximal subclavian artery stenosis and/or occlusion where the subclavian artery "drains" the blood from the vertebral artery. It sometimes induces neuromuscular symptoms, especially in cases with bilateral involvement. We report the case of a 65-year-old symptomatic male with severe bilateral SSS with complete vertebral reversal. Doppler ultrasonography yielded inconclusive results because of a scar in the left lower neck region leading to poor acoustic windows. Subsequent magnetic resonance imaging with contrast-enhanced magnetic resonance angiography and velocity-encoded phase-contrast magnetic resonance imaging provided the vascular morphology and blood flow pattern which allowed subsequent interventions to be successfully performed.


BACKGROUND
Angioplasty; Phase-contrast magnetic resonance imaging; Subclavian steal syndrome.
Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital; ; Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung; ; Division of Cardiology, Department of Internal Medicine, Nantou Hospital, Ministry of Health and Welfare, Nantou;
Yuan-Hung
YH
Yen
Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung; ; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan.
Teng-Fu
TF
Tsou
Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital; ; Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung;
Kai-Wei
KW
Chang
Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital; ; Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung;
Chin-Feng
CF
Tsai
Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital; ; Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung;
Chun-Hung
CH
Su