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MRI of thoracic outlet syndrome in children

Govind B Chavhan1, Vaishnavi Batmanabane2, Prakash Muthusami2,3

  • 1Department of Diagnostic Imaging, The Hospital for Sick Children and University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada. drgovindchavhan@yahoo.com.

Pediatric Radiology
|May 12, 2017
PubMed

Insights

Thoracic outlet syndrome results from neurovascular bundle compression in the thoracic outlet. Diagnosis involves clinical assessment, electrodiagnostic studies, and advanced MRI techniques to identify causes and guide treatment.

Area of Science:

  • Radiology
  • Anatomy
  • Neurology

Background:

  • Thoracic outlet syndrome (TOS) involves compression of the neurovascular bundle between the thorax and axilla.
  • Causes include bony abnormalities (e.g., first rib, cervical ribs) and soft-tissue issues (e.g., fibrous bands, muscle hypertrophy).
  • TOS affects young adults and children, necessitating accurate diagnosis.

Purpose of the Study:

  • To detail the anatomy of the thoracic outlet.
  • To outline the various causes of thoracic outlet syndrome.
  • To describe MR imaging techniques and interpretation principles for TOS diagnosis.

Main Methods:

  • Diagnosis integrates clinical presentation, physical examination, electrodiagnostic tests (EMG, NCS), and imaging.
  • MRI and MR angiography are crucial for confirming TOS, differentiating subtypes (neurogenic, arterial, venous), and excluding other conditions.
  • Specific MRI protocols include assessing anatomy, vessel patency in adduction, and dynamic compression in abduction.

Main Results:

  • Compression can stem from diverse anatomical variations and soft-tissue pathologies.
  • A comprehensive diagnostic approach is essential for accurate classification of TOS.
  • MRI, particularly with dynamic maneuvers, effectively visualizes vascular and neural compromise.

Conclusions:

  • Accurate anatomical and pathological assessment via MRI is vital for diagnosing thoracic outlet syndrome.
  • Understanding TOS etiology and imaging findings aids in effective patient management.
  • This review provides a framework for MR imaging and interpretation in suspected TOS.

Keywords:
ChildrenMagnetic resonance angiographyMagnetic resonance imagingThoracic outlet syndrome

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