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Simultaneous bilateral magnetic resonance angiography to evaluate thoracic outlet syndrome.
[thoracic outlet syndrome]
This
paper
presents
a
new
magnetic
resonance
angiography
(
MRA
)
protocol
for
the
evaluation
of
thoracic
outlet
syndrome
(
TOS
)
that
allows
for
a
separate
assessment
of
veins
and
arteries
while
using
a
single
,
simultaneous
and
bilateral
(
SB-MRA
)
single
contrast
injection
,
valid
for
both
abduction
and
adduction
acquisitions
.
From
2009
to
2013
we
performed
38
MRA
studies
for
clinically
suspected
TOS
(
13
M
,
25
F
;
mean
age
,
35
.
9
Â
years
;
σ
Â
=
Â
11
.
13
)
.
Twin
peripheral
20
G
intravenous
catheters
were
placed
in
a
cubital
vein
in
both
arms
and
connected
to
a
single
power
injector
by
two
lines
joined
with
a
connector
.
A
3
T
MR
system
with
a
wide
gantry
was
used
.
Two
groups
of
four
radiologists
assessed
all
the
images
.
Group
A
judged
the
full
examinations
,
Group
B
had
only
the
late
acquisitions
.
Differences
were
evaluated
using
the
Chi
square
test
.
TOS
was
confirmed
only
after
integration
with
the
clinical
history
.
Seventeen
(
45
Â
%
)
patients
were
diagnosed
with
predominant
venous
TOS
(
VTOS
)
,
nine
(
24
Â
%
)
with
predominant
arterial
TOS
(
ATOS
)
and
12
(
32
Â
%
)
had
an
indeterminate
or
nonvascular
condition
.
Group
A
radiologists
identified
significantly
more
VTOS
than
group
B
(
p
Â
=
Â
0
.
049
)
.
Interobserver
agreement
was
very
high
.
SB-MRA
is
a
safe
and
reliable
protocol
for
the
study
of
TOS
.
It
provides
a
supplementary
early
acquisition
that
allows
for
separate
assessment
of
veins
and
arteries
,
permits
the
investigation
of
the
collateral
venous
flow
with
a
single
injection
of
contrast
material
and
provides
a
higher
diagnostic
power
for
VTOS
.
SB-MRA
is
helpful
for
the
diagnosis
of
TOS
of
vascular
origin
.
