ACR Appropriateness Criteria Imaging in the Diagnosis of Thoracic Outlet Syndrome

Moriarty, John M.; Bandyk, Dennis F.; Broderick, Daniel F.; Cornelius, Rebecca S.; Dill, Karin E.; François, Christopher J.; Gerhard‐Herman, Marie; Ginsburg, Mark E.; Hanley, Michael; Kalva, Sanjeeva P.; Kanne, Jeffrey P.; Ketai, Loren H.; Majdalany, Bill S.; Ravenel, James G.; Roth, Christopher J.; Saleh, Anthony G.; Schenker, Matthew P.; Mohammed, Tan-Lucien; Rybicki, Frank J.

doi:10.1016/j.jacr.2015.01.016

Cited by 44 publications

(52 citation statements)

References 46 publications

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“…The radiologist plays an important role in initial evaluation of patients with suspected TOS. Although the main cornerstones of diagnosis are the patient's presenting history and physical examination, imaging studies can be helpful to confirm the diagnosis or site of involvement, delineate abnormal anatomy, evaluate for other potential causes of the patient's symptoms, and appropriately classify the patient's condition as neurogenic TOS, arterial TOS, or venous TOS (23). Chest radiography is typically performed in all patients with suspected TOS, as it can help delineate bone abnormalities.…”

Section: Imaging In Diagnosis Of Tosmentioning

confidence: 99%

“…Conventional radiography should be performed in all patients with suspected TOS and serves as a low-cost means of identifying a bone anatomic abnormality (23). Even if a patient with suspected TOS is scheduled to undergo MR imaging, conventional radiography is still indicated, as cervical ribs and other bone abnormalities can be missed at MR imaging (35).…”

Section: Conventional Radiographymentioning

confidence: 99%

“…MR imaging is the noninvasive cross-sectional imaging test of choice in patients with suspected TOS (23). Given that the evaluation for positional narrowing requires imaging acquisitions in multiple positions, MR imaging has an inherent advantage over CT due to its lack of ionizing radiation, an advantage of particular benefit in the generally young patient population affected by TOS.…”

Section: Mr Imagingmentioning

confidence: 99%

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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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Section: Imaging In Diagnosis Of Tosmentioning

confidence: 99%

Section: Conventional Radiographymentioning

confidence: 99%

Section: Mr Imagingmentioning

confidence: 99%

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Imaging of the Patient with Thoracic Outlet Syndrome

Raptis¹,

Sridhar²,

Thompson³

et al. 2016

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“…Однако правильная поста-новка задачи и методически адекватно проведенное МР-исследование могут значительно помочь клини-цисту, особенно при отсутствии электрофизиологиче-ских изменений [23,46,47]. Информативность МРТ в диагностике TOS возрастает при ее выполнении с позиционными пробами и провокационными теста-ми [47][48][49].…”

Section: инструментальная диагностикаunclassified

Thoracic outlet syndrome: clinical and diagnostic features

Муртазина¹,

Никитин²,

Наумова³

2017

Neuromuscular Diseases

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“…A chest X-ray is an appropriate first test when suspecting the thoracic outlet syndrome. It is a cheap and a safe modality to detect bone abnormalities [53]. Magnetic Resonance (MR) venography is difficult for the patients [54], yet appropriate for the diagnosis of the thoracic outlet syndrome [53].…”

Section: Others Imaging Modalitymentioning

confidence: 99%

Upper Extremity Deep Venous Thrombosis (UEDVT)

Badr¹

2015

Intern Med

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Upper extremity Deep Venous Thrombosis (UEDVT) is frequent in the hospital, especially in the intensive care unit. It often complicates the placement of central venous catheters (CVC), notably peripherally inserted central (PICC) lines. Despite a lower rate of pulmonary embolism, UEDVT is as fatal as lower extremity DVT. This is due to its strong association with cancer. Symptoms are often absent, but systematic screening is not recommended. The best prophylaxis is good central catheter management. Pharmacological prophylaxis has questionable effectiveness in the prophylaxis of CVC-associated UEDVT. Compression ultrasonography is the first line diagnostic tool. Treatment is anticoagulation for at least 3 months. A causative central line should be removed as soon as clinically possible. Infrequently, patients with the thoracic outlet syndrome can get an effort related primary UEDVT. It is also known as the Paget-Schroetter syndrome. Along with anticoagulation, surgical referral for decompression of the thoracic outlet is then necessary. The current state of evidence on UEDVT is rather poor, due to the absence of large randomized controlled trials.

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ACR Appropriateness Criteria Imaging in the Diagnosis of Thoracic Outlet Syndrome

Cited by 44 publications

References 46 publications

Imaging of the Patient with Thoracic Outlet Syndrome

Imaging of the Patient with Thoracic Outlet Syndrome

Thoracic outlet syndrome: clinical and diagnostic features

Upper Extremity Deep Venous Thrombosis (UEDVT)

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