MRI of thoracic outlet syndrome in children

Thoracic outlet syndrome is caused by compression of the neurovascular bundle as it passes from the upper thorax to the axilla. The neurovascular bundle can be compressed by bony structures such as the first rib, cervical ribs or bone tubercles, or from soft-tissue abnormalities like a fibrous band,...

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Bibliographic Details
Published in:Pediatric radiology 2017-09, Vol.47 (10), p.1222-1234
Main Authors: Chavhan, Govind B., Batmanabane, Vaishnavi, Muthusami, Prakash, Towbin, Alexander J., Borschel, Gregory H.
Format: Article
Language:English
Subjects:
Abnormalities
Adults
Anatomy
Angiography
Blood vessels
Bundling
Child
Children
Compression
Compression tests
Diagnosis
Diagnosis, Differential
Electromyography
Humans
Hypertrophy
Imaging
Imaging techniques
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Maneuvers
Medical imaging
Medicine
Medicine & Public Health
Nerve conduction
Neuroradiology
Nuclear Medicine
Oncology
Pediatrics
Radiology
Review
Rib
Ribs
Ribs (structural)
Thoracic Outlet Syndrome - diagnostic imaging
Thorax
Ultrasound
Young adults
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Summary:Thoracic outlet syndrome is caused by compression of the neurovascular bundle as it passes from the upper thorax to the axilla. The neurovascular bundle can be compressed by bony structures such as the first rib, cervical ribs or bone tubercles, or from soft-tissue abnormalities like a fibrous band, muscle hypertrophy or space-occupying lesion. Thoracic outlet syndrome commonly affects young adults but can be seen in the pediatric age group, especially in older children. Diagnosis is based on a holistic approach encompassing clinical features, physical examination findings including those triggered by various maneuvers, electromyography, nerve conduction studies and imaging. Imaging is performed to confirm the diagnosis, exclude mimics and classify thoracic outlet syndrome into neurogenic, arterial, venous or mixed causes. MRI and MR angiography are useful in this process. A complete MRI examination for suspected thoracic outlet syndrome should include the assessment of anatomy and any abnormalities using routine sequences, vessel assessment with the arms in adduction by MR angiography and assessment of dynamic compression of vessels with abduction of the arms. The purpose of this paper is to describe the anatomy of the thoracic outlet, causes of thoracic outlet syndrome, the MR imaging techniques used in its diagnosis and the principles of image interpretation.
ISSN:0301-0449
1432-1998
DOI:10.1007/s00247-017-3854-5