Sonographic evaluation of the subclavian artery during thoracic outlet syndrome shoulder manoeuvres

Stapleton, Claire; Herrington, Lee; George, Keith

doi:10.1016/j.math.2007.07.010

Cited by 29 publications

(21 citation statements)

References 10 publications

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“…Previous studies have also reported that venous compression is frequently observed in asymptomatic individuals in all the compartments of the thoracic outlet after arm elevation [16,19,20,23]. Therefore, contrast-enhanced 3D MRA alone cannot establish a confident diagnosis of vascular TOS, and treatment decisions based on false-positive outcomes have serious implications for mistreatment, such as inappropriate surgical intervention.…”

Section: D Mr Angiography Of Vascular Thoracic Outlet Syndromementioning

confidence: 99%

Vascular Thoracic Outlet Syndrome: Protocol Design and Diagnostic Value of Contrast-Enhanced 3D MR Angiography and Equilibrium Phase Imaging on 1.5- and 3-T MRI Scanners

Ersoy

Steigner

Coyner

et al. 2012

American Journal of Roentgenology

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Contrast-enhanced 3D MRA using provocative arm positioning allows excellent imaging of the arteries and veins on both sides and thus provides a noninvasive imaging alternative to digital subtraction angiography in patients with suspected vascular TOS. Contrast-enhanced 3D MRA is also an ideal imaging modality for postsurgical follow-up for identifying restenosis or residual vascular compression. However, all imaging studies, including the contrast-enhanced 3D MRA protocol described here, should be treated as complementary tests for the diagnosis of TOS.

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Section: D Mr Angiography Of Vascular Thoracic Outlet Syndromementioning

confidence: 99%

Vascular Thoracic Outlet Syndrome: Protocol Design and Diagnostic Value of Contrast-Enhanced 3D MR Angiography and Equilibrium Phase Imaging on 1.5- and 3-T MRI Scanners

Ersoy

Steigner

Coyner

et al. 2012

American Journal of Roentgenology

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“…Venous compression is much more common, however, and occurs in over 50% of asymptomatic patients (7,24,25). Similar findings have been reflected in US studies of normal patients, which have demonstrated variability of vessel caliber and flow patterns in the axillosubclavian vessels with positional changes (26)(27)(28). Labeling patients with vascular compression alone as having TOS can lead to misdiagnosis and potentially overtreatment with surgical intervention (Fig 2).…”

Section: Imaging In Diagnosis Of Tosmentioning

confidence: 56%

Imaging of the Patient with Thoracic Outlet Syndrome

Raptis¹,

Sridhar²,

Thompson³

et al. 2016

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Patients with symptoms from compression of the neurovascular bundle in the thoracic outlet are described as having thoracic outlet syndrome (TOS), which is best thought of as three conditions classified according to which structures are involved. The purpose of this article is to review the role of imaging in evaluation of patients with TOS, beginning with diagnosis and extending through postoperative management. While diagnosis of TOS still rests on the patient's presenting history and physical examination, imaging examinations are helpful in supporting the diagnosis, delineating abnormal anatomy, determining which structures are compressed, identifying the site of compression, and excluding other diagnoses. Magnetic resonance imaging is the noninvasive imaging modality of choice in evaluating patients with suspected TOS, but computed tomography also plays an important role, particularly in delineating bone anatomy. Evidence of vascular damage is required to make the diagnosis of TOS at imaging. Dynamic compression of the axillosubclavian vessels at the thoracic outlet can be a finding supportive of the diagnosis of TOS but is not a stand-alone diagnostic criterion, as it can be seen in patients without TOS. As diagnosis and treatment of TOS increase, radiologists will increasingly encounter the TOS patient after decompression surgery. Recognition of the expected postoperative appearance of these patients is critical, as is an understanding of the imaging findings of potential short- and long-term complications. (©)RSNA, 2016.

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“…16,17 Because we only measured the vessel with the arm fully adducted, we cannot compare our results with those who studied the effects of varying degrees of arm abduction on the CSA or the PSV of the subclavian artery. The CSA of the subclavian arteries in the cited reports was not published; a percentage of stenosis 16 and vessel diameter 17 were published.…”

Section: Discussionmentioning

confidence: 99%

“…In previous attempts to diagnose TOS using ultrasonography, the peak systolic velocity (PSV) of the subclavian/axillary artery has been an important measure used to detect vessel stenosis or occlusion of flow. 16,17 The purpose of this study was to establish a reference range of values for the CSA of the brachial plexus, subclavian artery, and PSV of the subclavian artery in healthy subjects using ultrasonography.…”

mentioning

confidence: 99%

Normative Cross-Sectional Area of the Brachial Plexus and Subclavian Artery Using Ultrasonography

Haun

Cho

Clark

et al. 2009

Journal of Manipulative and Physiological Therapeutics

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Sonographic evaluation of the subclavian artery during thoracic outlet syndrome shoulder manoeuvres

Cited by 29 publications

References 10 publications

Vascular Thoracic Outlet Syndrome: Protocol Design and Diagnostic Value of Contrast-Enhanced 3D MR Angiography and Equilibrium Phase Imaging on 1.5- and 3-T MRI Scanners

Vascular Thoracic Outlet Syndrome: Protocol Design and Diagnostic Value of Contrast-Enhanced 3D MR Angiography and Equilibrium Phase Imaging on 1.5- and 3-T MRI Scanners

Imaging of the Patient with Thoracic Outlet Syndrome

Normative Cross-Sectional Area of the Brachial Plexus and Subclavian Artery Using Ultrasonography

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