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 years; sigma = 11.13). Twin peripheral 20G 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 3T 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 %) patients were diagnosed with predominant venous TOS (VTOS), nine (24 %) with predominant arterial TOS (ATOS) and 12 (32 %) had an indeterminate or nonvascular condition. Group A radiologists identified significantly more VTOS than group B (p = 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.
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Washington Univ, Sch Med, Mallinckrodt Inst Radiol, St Louis, MO USAWashington Univ, Sch Med, Mallinckrodt Inst Radiol, St Louis, MO USA
Ludwig, Daniel R.
Shetty, Anup S.
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Washington Univ, Sch Med, Mallinckrodt Inst Radiol, St Louis, MO USAWashington Univ, Sch Med, Mallinckrodt Inst Radiol, St Louis, MO USA
Shetty, Anup S.
Broncano, Jordi
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Hosp Cruz Roja & San Juan Dios, Cardiothorac Imaging Sect, Hlth Time, Cordoba, SpainWashington Univ, Sch Med, Mallinckrodt Inst Radiol, St Louis, MO USA
Broncano, Jordi
Bhalla, Sanjeev
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Washington Univ, Sch Med, Mallinckrodt Inst Radiol, St Louis, MO USAWashington Univ, Sch Med, Mallinckrodt Inst Radiol, St Louis, MO USA
Bhalla, Sanjeev
Raptis, Constantine A.
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Washington Univ, Sch Med, Mallinckrodt Inst Radiol, St Louis, MO USAWashington Univ, Sch Med, Mallinckrodt Inst Radiol, St Louis, MO USA
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Tokyo Womens Med Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, Tokyo 1628666, JapanTokyo Womens Med Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, Tokyo 1628666, Japan
Fukaya, Eri
Saloner, David
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Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USATokyo Womens Med Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, Tokyo 1628666, Japan
Saloner, David
Leon, Pablo
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Univ Calif San Francisco, Dept Surg, Div Plast Surg, San Francisco, CA 94143 USATokyo Womens Med Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, Tokyo 1628666, Japan
Leon, Pablo
Wintermark, Max
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Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USATokyo Womens Med Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, Tokyo 1628666, Japan
Wintermark, Max
Grossman, Richard F.
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Univ Calif San Francisco, Dept Surg, Div Plast Surg, San Francisco, CA 94143 USATokyo Womens Med Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, Tokyo 1628666, Japan
Grossman, Richard F.
Nozaki, Motohiro
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Tokyo Womens Med Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, Tokyo 1628666, JapanTokyo Womens Med Univ, Dept Plast & Reconstruct Surg, Shinjuku Ku, Tokyo 1628666, Japan
机构:
Univ Wisconsin, Dept Radiol, Madison, WI 53792 USA
Univ Hosp Hamburg Eppendorf, Dept Radiol, D-20246 Hamburg, GermanyUniv Wisconsin, Dept Radiol, Madison, WI 53792 USA
Bannas, Peter
Francois, Christopher J.
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Univ Wisconsin, Dept Radiol, Madison, WI 53792 USAUniv Wisconsin, Dept Radiol, Madison, WI 53792 USA
Francois, Christopher J.
Reeder, Scott B.
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Univ Wisconsin, Dept Radiol, Madison, WI 53792 USA
Univ Wisconsin, Dept Biomed Engn, Madison, WI 53706 USA
Univ Wisconsin, Dept Med Phys, Madison, WI 53705 USA
Univ Wisconsin, Dept Med, Madison, WI 53705 USA
Univ Wisconsin, Dept Emergency Med, Madison, WI 53792 USAUniv Wisconsin, Dept Radiol, Madison, WI 53792 USA
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Univ Calif Davis, Div Vasc Surg, 2335 Stockton Blvd,NAOB 5001, Sacramento, CA 95811 USAUniv Calif Davis, Div Vasc Surg, 2335 Stockton Blvd,NAOB 5001, Sacramento, CA 95811 USA
Cralle, Lauren E.
Harris, Linda M.
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Univ Calif Davis, Div Vasc Surg, 2335 Stockton Blvd,NAOB 5001, Sacramento, CA 95811 USAUniv Calif Davis, Div Vasc Surg, 2335 Stockton Blvd,NAOB 5001, Sacramento, CA 95811 USA
Harris, Linda M.
Lum, Ying Wei
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Univ Buffalo, Buffalo, NY USA
Johns Hopkins Univ, Baltimore, MD USAUniv Calif Davis, Div Vasc Surg, 2335 Stockton Blvd,NAOB 5001, Sacramento, CA 95811 USA
Lum, Ying Wei
Deery, Sarah E.
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Maine Med Ctr, Portland, ME USAUniv Calif Davis, Div Vasc Surg, 2335 Stockton Blvd,NAOB 5001, Sacramento, CA 95811 USA
Deery, Sarah E.
Humphries, Misty D.
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Univ Calif Davis, Div Vasc Surg, 2335 Stockton Blvd,NAOB 5001, Sacramento, CA 95811 USAUniv Calif Davis, Div Vasc Surg, 2335 Stockton Blvd,NAOB 5001, Sacramento, CA 95811 USA