Simultaneous bilateral magnetic resonance angiography to evaluate thoracic outlet syndrome

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Abstract

Purpose: 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. Materials and methods: From 2009 to 2013 we performed 38 MRA studies for clinically suspected TOS (13 M, 25 F; mean age, 35.9 years; σ = 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. Results: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)407-412
Number of pages6
JournalRadiologia Medica
Volume120
Issue number5
DOIs
Publication statusPublished - May 1 2015

Fingerprint

Thoracic Outlet Syndrome
Magnetic Resonance Angiography
Veins
Arteries
Injections
Chi-Square Distribution
Contrast Media
Blood Vessels
Catheters

Keywords

  • 3T
  • 3Tesla
  • Angiography
  • Magnetic resonance angiography
  • MRA
  • SB-MRA
  • Simultaneous bilateral injection
  • Thoracic outlet syndrome
  • TOS

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

@article{9aeac3bf10284fd08960a52b9a62f345,
title = "Simultaneous bilateral magnetic resonance angiography to evaluate thoracic outlet syndrome",
abstract = "Purpose: 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. Materials and methods: From 2009 to 2013 we performed 38 MRA studies for clinically suspected TOS (13 M, 25 F; mean age, 35.9 years; σ = 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. Results: 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. Conclusions: 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.",
keywords = "3T, 3Tesla, Angiography, Magnetic resonance angiography, MRA, SB-MRA, Simultaneous bilateral injection, Thoracic outlet syndrome, TOS",
author = "Dario Poretti and Ezio Lanza and Sconfienza, {Luca Maria} and Giovanni Mauri and Vittorio Pedicini and Luca Balzarini and Francesco Sardanelli",
year = "2015",
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doi = "10.1007/s11547-014-0462-4",
language = "English",
volume = "120",
pages = "407--412",
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T1 - Simultaneous bilateral magnetic resonance angiography to evaluate thoracic outlet syndrome

AU - Poretti, Dario

AU - Lanza, Ezio

AU - Sconfienza, Luca Maria

AU - Mauri, Giovanni

AU - Pedicini, Vittorio

AU - Balzarini, Luca

AU - Sardanelli, Francesco

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Purpose: 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. Materials and methods: From 2009 to 2013 we performed 38 MRA studies for clinically suspected TOS (13 M, 25 F; mean age, 35.9 years; σ = 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. Results: 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. Conclusions: 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.

AB - Purpose: 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. Materials and methods: From 2009 to 2013 we performed 38 MRA studies for clinically suspected TOS (13 M, 25 F; mean age, 35.9 years; σ = 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. Results: 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. Conclusions: 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.

KW - 3T

KW - 3Tesla

KW - Angiography

KW - Magnetic resonance angiography

KW - MRA

KW - SB-MRA

KW - Simultaneous bilateral injection

KW - Thoracic outlet syndrome

KW - TOS

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U2 - 10.1007/s11547-014-0462-4

DO - 10.1007/s11547-014-0462-4

M3 - Article

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JO - Radiologia Medica

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