الفهرس 
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Abstract
The aim of this work is to evaluate the role of contrast enhanced MR Angiography in assessment and diagnosis of the upper limb arterial lesions. The study was conducted in Radiology department of Mansoura University Hospitals on 26 patients. Their ages ranged from 10 to 70 years (mean 44 years). These patients were 12 males and 14 females. All patients were referred from vascular surgery unit. They were presented by ischemic pain (n=23), swelling (n=6), thrill (n=3). All patients underwent contrast enhanced-magnetic resonance angiography. Intra arterial digital subtraction angiography was done for 7 patients within one week. In Burger’s disease (n=4) there was multiple segmental stenoses of the common digital arteries with multiple proper digital occlusions without evidence of collateralization attenuated ulnar artery. Systemic lupus erthymatosus (n=2) the most common involvement is of the proper digital arteries, with marked reduction in digital blood supply, tapered and/or abrupt occlusions, and prominent collateralization Rheumatoid arthritis (n=2) most of the stenotic lesions in rheumatoid patients occur at the level of the proper digital and ulnar arteries, with greatest involvement in those digits more severely involved by arthritic changes Systemic scleroderma (n=2) there was multiple occlusive lesions in the proper digital arteries with involvement of the ulnar artery. Radial artery was almost always normal. As well as the palmar arch and common digital arteries. Pseudoaneurysm (n=1) there was contrast filled outpouching arising from the vascular wall. Micro emboli (n=1) produce segmental occlusions of the common and proper digital arteries with abrupt termination of the blood flow. Intra-arterial injection (n=1) there was attenuated distal ulnar artery and occlusions of the 3rd, 4th, 5th proper digital arteries. Haemangiomas (n=1) normal radial and ulnar arteries with vascular lesions are visualized, which remain opacified late into the venous phase. Arteriovenous malformation (n=1) multiple dilated tortuous arterial and venous channels. Steal phenomena (n=4) there was deficient perfusion of the fingers or even the entire hand. While the vascular disorders in the arm and forearm cases were as follow Hemangioma (n=2) there were large vascular mass connected to the brachial artery by feeding vessels and few draining veins A.V.M (n=1) there was multiple dilated tortuous arterial and venous channels. True aneurysm (n=1) there was fusiform aneurysmal dilatation of the midbrachial artery Traumatic AVF (n=1) there was early filling of the venous system during the arterial phase. Intra-arterial Injection (n=1) there was occlusion of most the radial artery. While the vascular disorders in the shoulder region are Subclavian occlusion (n=1) with collaterals are seen around. Takayasu’s disease (n=1) there was bilateral irregularities along the course of both subclavian, axillary arteries. We conclude that CE-MRA provide an excellent promising noninvasive tool in examination of the upper limb arterial vascular disorders using the optimal technique, adequate short acquisition time to prevent venous contamination and adequate rate of injection resulting in good opacification of the arterial system of the upper limb as well as the small arteries of the hand, this makes CE-MRA is a robust technique that can be used for preoperative mapping of the arterial system of the upper limb helping in the planning of effective line of management plus it helps in monitoring for further growth or recur following surgery. So we recommend that CE-MRA should be the first modality of choice and done for all patients with suspected vascular disorders of the upper limb.