HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sheehy, N. Articles by Meaney, J. F. M. Search for Related Content PubMed PubMed Citation Articles by Sheehy, N. Articles by Meaney, J. F. M. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Contrast-Enhanced MR Angiography of Subclavian Steal Syndrome: Value of the 2D Time-of-Flight "Localizer" Sign

¹ Department of Diagnostic Imaging, St. James's Hospital, James's St., Dublin 8, Ireland.
² Department of Vascular Surgery, St. James's Hospital, Dublin 8, Ireland.

View larger version (61K): [in a new window]   Fig. 1A —63-year-old woman. Reformatted maximum-intensity-projection (A) and sample axial image (B) from 2D time-of-flight localizer in healthy patient undergoing 3D contrast-enhanced MR angiography at our institution. Vertebral arteries are visible, indicating normal flow direction and absence of severe vertebral disease.

View larger version (73K): [in a new window]   Fig. 1B —63-year-old woman. Reformatted maximum-intensity-projection (A) and sample axial image (B) from 2D time-of-flight localizer in healthy patient undergoing 3D contrast-enhanced MR angiography at our institution. Vertebral arteries are visible, indicating normal flow direction and absence of severe vertebral disease.

View larger version (112K): [in a new window]   Fig. 2A —70-year-old woman with suspected subclavian steal syndrome and flow reversal on Doppler sonography. Occlusion is seen within left subclavian artery proximal to veterbral artery origin, shown on high-resolution 3D contrast-enhanced MR angiography (CEMRA) maximum-intensity-projection (MIP) image. The left vertebral artery appears normal (A). The normal left vertebral artery can also be seen on axial reformat of data (B). Corresponding reformatted MIP (C) and axial (D) images from 2D time-of-flight localizer show flow void in left vertebral artery, despite visualization of normal right vertebral artery on 3D CEMRA. This indicates flow reversal within vertebral artery ("localizer" sign).

View larger version (37K): [in a new window]   Fig. 2B —70-year-old woman with suspected subclavian steal syndrome and flow reversal on Doppler sonography. Occlusion is seen within left subclavian artery proximal to veterbral artery origin, shown on high-resolution 3D contrast-enhanced MR angiography (CEMRA) maximum-intensity-projection (MIP) image. The left vertebral artery appears normal (A). The normal left vertebral artery can also be seen on axial reformat of data (B). Corresponding reformatted MIP (C) and axial (D) images from 2D time-of-flight localizer show flow void in left vertebral artery, despite visualization of normal right vertebral artery on 3D CEMRA. This indicates flow reversal within vertebral artery ("localizer" sign).

View larger version (90K): [in a new window]   Fig. 2C —70-year-old woman with suspected subclavian steal syndrome and flow reversal on Doppler sonography. Occlusion is seen within left subclavian artery proximal to veterbral artery origin, shown on high-resolution 3D contrast-enhanced MR angiography (CEMRA) maximum-intensity-projection (MIP) image. The left vertebral artery appears normal (A). The normal left vertebral artery can also be seen on axial reformat of data (B). Corresponding reformatted MIP (C) and axial (D) images from 2D time-of-flight localizer show flow void in left vertebral artery, despite visualization of normal right vertebral artery on 3D CEMRA. This indicates flow reversal within vertebral artery ("localizer" sign).

View larger version (58K): [in a new window]   Fig. 2D —70-year-old woman with suspected subclavian steal syndrome and flow reversal on Doppler sonography. Occlusion is seen within left subclavian artery proximal to veterbral artery origin, shown on high-resolution 3D contrast-enhanced MR angiography (CEMRA) maximum-intensity-projection (MIP) image. The left vertebral artery appears normal (A). The normal left vertebral artery can also be seen on axial reformat of data (B). Corresponding reformatted MIP (C) and axial (D) images from 2D time-of-flight localizer show flow void in left vertebral artery, despite visualization of normal right vertebral artery on 3D CEMRA. This indicates flow reversal within vertebral artery ("localizer" sign).

View larger version (76K): [in a new window]   Fig. 3A —Another patient with proximal right subclavian artery stenosis and normal right vertebral artery on 3D contrast-enhanced MR angiography maximum intensity projection (A). Axial image from 2D time-of-flight localizer again shows flow void in right vertebral artery, indicating flow reversal (B).

View larger version (63K): [in a new window]   Fig. 3B —Another patient with proximal right subclavian artery stenosis and normal right vertebral artery on 3D contrast-enhanced MR angiography maximum intensity projection (A). Axial image from 2D time-of-flight localizer again shows flow void in right vertebral artery, indicating flow reversal (B).

View larger version (105K): [in a new window]   Fig. 4A —Patient shows severe atherosclerotic stenosis of right vertebral artery (A). 2D time-of-flight localizer shows flow void (B), this time due to severe vertebral disease shown on 3D contrast-enhanced MR angiography sequences.

View larger version (106K): [in a new window]   Fig. 4B —Patient shows severe atherosclerotic stenosis of right vertebral artery (A). 2D time-of-flight localizer shows flow void (B), this time due to severe vertebral disease shown on 3D contrast-enhanced MR angiography sequences.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati