Contrast-enhanced three-dimensional MR angiography in the assessment of subclavian artery diseases

The purpose of this prospective study was to determine the potential diagno stic value of 3D breath-hold contrast-enhanced MRA (CEMRA) in the evaluatio n of subclavian artery pathology, and to compare CEMRA and digital subtract ion angiography (DSA) findings. The study group included 50 patients with s uspicion of subclavian artery pathology: 40 suspected steno-occlusive disea se and 10 different vascular anomalies. The MRA examinations were performed on a 1.5-T system using fast 3D sequences. A fixed dose of 40 mi Gd-DTPA w as administered at 2 m/ls after previous bolus tracking. Images were analyz ed to assess: subclavian depiction; luminal changes; collateral branches; a nd feeders of arterial venous malformations (AVM). A multireader blinded fa shion was used. The CEMRA revealed an optimal agreement with DSA findings i n the different types of diseases. Sensitivity and specificity were 90 and respectively, in detecting steno-occlusive dis(including functional and art eritic stenoses), and 100 and 100%, respectively, in cases of Vascular anom alies (dilation, kinking, anomalous origin and AVM). Contrast-enhanced MRA can be proposed as a non-invasive, robust technique for imaging subclavian pathologies with high diagnostic performance.