Diagnostic Value of Magnetic Resonance Imaging in Thoracic Outlet Syndrome

Abstract

PURPOSE. To evaluate the diagnostic value of magnetic resonance imaging (MRI) in thoracic outlet syndrome (TOS). METHODS. Medical records of 30 women and 10 men aged 18 to 68 (mean, 38) years who presented with unilateral (n=35) and bilateral (n=5) TOS and underwent 42 surgical decompressions of the right (n=23) and left (n=19) sides were reviewed. MRI findings were compared with intra-operative findings to evaluate the diagnostic value of MRI. RESULTS. MRI findings correlated poorly with intra-operative findings. Of the 42 cases, MRI and intra-operative findings were matched in 17 and not matched in 25. MRI appeared normal but intra-operative findings were in fact positive for TOS in 23 of 24 cases. The sensitivity and specificity of MRI in diagnosing TOS were 41% and 33%, respectively, whereas its positive and negative predictive values were 89% and 4%, respectively. CONCLUSION. Sensitivity and specificity of MRI in diagnosing TOS are low. Diagnosis should be based on a holistic approach including history, clinical examination, and radiological findings.

Clinical Osteopathic Observation of Patients with Left-Ventricular Assistance Device

“…Palpation has highlighted a first rib in elevation and hypertonia of the subclavius and pectoralis minor muscle in the side in dysfunction. These dysfunctions lead to thoracic outlet syndrome, although we did not run specific surveys to diagnose the cause, such as a vascular or neurological compression [23,24].…”

Thoracic outlet syndrome arising from an extrapleural lipoma

“…MRI is considered most efficacious for neurogenic TOS, which is often the most difficult form to diagnose. 6 The detailed appreciation of soft tissues on MRI may highlight irritation of the brachial plexus as high signal on T2-weighted sequences. 2 The loss of fat planes surrounding the brachial plexus or close contact with surrounding bone structures is considered pathognomonic of neurogenic TOS.…”

New Diagnostic and Treatment Modalities for Neurogenic Thoracic Outlet Syndrome

“…This study demonstrated poor correlation between MRI and intraoperative findings. The sensitivity and specificity of MRI for diagnosis of TOS in this study was 41% and 33%, respectively [7]. Alternatively, MR Neurography (MRN) shows potential as a beneficial diagnostic tool for nTOS [8].…”