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.