Velocity-Encoded Phase-Contrast Magnetic Resonance Imaging for Diagnosing Severe Bilateral Subclavian Steal Syndrome with Complete Vertebral Reversal.

UNLABELLED 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. KEY WORDS Angioplasty; Phase-contrast magnetic resonance imaging; Subclavian steal syndrome.