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MRA: Upper Extremity and Hand Vessels

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Book cover Magnetic Resonance Angiography

Abstract

Catheter angiography is the acknowledged clinical gold standard for upper extremity arterial assessment. However, it is invasive and can be particularly challenging in the upper extremity, as iodinated contrast injection can initiate vasospasm and pain, particularly in young adults. MR evaluation of the upper extremity and hand vessels can provide a noninvasive comprehensive assessment, particularly since the advent of gadolinium-enhanced MRA (Gd MRA) in the early 1990s [1]. Indications for upper extremity MR angiography or venography are varied, including atherosclerosis, trauma, thromboembolic phenomena, and vasculitides. Benefits of MRA include lack of ionizing radiation, no requirement for iodinated contrast, and ability to acquire functional information including flow direction and velocity. Advances in magnet and coil technology have enabled continued improvements in spatial and/or temporal resolution. For successful imaging, a clear understanding of vascular anatomy, patient preparation, imaging protocols, and potential pathology is required. Some potential challenges that are faced when evaluating the arm are small caliber distal vessels, anatomic variants, relatively slow blood flow, and short arteriovenous transit times.

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Acknowledgments

We wish to thank Martha Helmers for her expert illustration and assistance with preparation of the figures.

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Authors and Affiliations

  1. Department of Radiology, New York University Langone Medical Center, New York, NY, USA

    Ruth P. Lim MBBS, MMed, FRANZCR & Vivian S. Lee MD, PhD, MBA

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  1. Ruth P. Lim MBBS, MMed, FRANZCR
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  2. Vivian S. Lee MD, PhD, MBA
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Corresponding author

Correspondence to Ruth P. Lim MBBS, MMed, FRANZCR .

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Editors and Affiliations

  1. Feinberg School of Medicine, Northwestern University, N. Michigan Ave. 737, Chicago, 60611, Illinois, USA

    James C. Carr

  2. Feinberg School of Medicine, Northwestern University, N. Michigan Ave. 737, Chicago, 60611, Illinois, USA

    Timothy J. Carroll

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Lim, R.P., Lee, V.S. (2012). MRA: Upper Extremity and Hand Vessels. In: Carr, J., Carroll, T. (eds) Magnetic Resonance Angiography. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1686-0_22

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  • DOI: https://doi.org/10.1007/978-1-4419-1686-0_22

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-1685-3

  • Online ISBN: 978-1-4419-1686-0

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