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Helical computed tomography of the normal thoracic outlet
J S Matsumura1, W S Rilling, W H Pearce
1Department of Surgery, Northwestern University Medical School, Chicago, IL, USA.
Journal of Vascular Surgery
|December 31, 1997
Summary
Thoracic outlet anatomy in healthy individuals was studied using CT scans. Arm movement significantly narrows spaces, causing universal venous compression and occasional minor arterial narrowing.
Area of Science:
- Radiology
- Anatomy
- Vascular Medicine
Background:
- The thoracic outlet is a complex anatomical region.
- Understanding its dimensions is crucial for diagnosing thoracic outlet syndrome.
- Vascular compression in this area can lead to significant symptoms.
Purpose of the Study:
- To detail thoracic outlet anatomy in asymptomatic individuals.
- To assess vascular compression with arm movement using helical CT.
- To correlate anatomical changes with arm positioning.
Main Methods:
- Ten volunteers underwent helical CT scans with arms in neutral and abducted positions.
- Measurements included anterior scalene-clavicle (SC) and costoclavicular (CC) distances.
- Vessel diameters were measured and compared between positions using statistical analysis.
Main Results:
- Arm abduction significantly reduced SC and CC distances (p < 0.001).
- Venous diameter decreased significantly with arm abduction (p < 0.001).
- Arterial diameter showed minor, less frequent narrowing (p = 0.001 for one position).
Conclusions:
- Arm abduction markedly reduces thoracic outlet dimensions.
- Venous compression is common in normal subjects with arm movement.
- Minor anatomical variations in SC/CC distances may predispose to venous compression even without extreme movement.