Suboptimal contrast-enhanced carotid MR angiography from the left brachiocephalic venous stasis

The purpose of this study was to evaluate left brachiocephalic venous stasi s and its relationship to suboptimal contrast-enhanced carotid magnetic res onance angiography (MRA). Two groups of patients (group 1, 475 patients; gr oup 2, 159 patients) were examined by contrast-enhanced carotid MRA. Dynami c images of four serial phases were obtained by a three-dimensional fast lo w-angle shot (3D-FLASH) MRA sequence after bolus injection of 20 ml of gado linium chelate. In group 1, 43 (9.1%) of 475 cases failed in optimal visual ization of carotid arteries because of venous stasis, Left-side Injection o f contrast media was significantly related to venous stasis (42/43) (P < 0. 0001), The patients with venous stasis had a higher mean age (54.8 +/- 1.5 vs. 60.7 +/- 2.9 years) and higher incidence of hypertension (52.8% vs. 72. 1%; P < 0.05), Venous stasis was found at the left brachiocephalic vein (42 /43), Compression of the left brachiocephalic vein between the sternum and aorta was confirmed in four cases by venography, chest computed tomography, and magnetic resonance imaging. In group 2, right-side injection did not c ause venous stasis at all, The results of this study suggest that use of th e right arm for contrast media injection is preferable in the absence of co ntraindications. (C) 1999 Wiley-Liss, Inc.