Efficacy of Three-Dimensional Contrast-Enhanced Magnetic Resonance Angiography (3D CE-MRA) in the Diagnosis of Thoracic Outlet Syndrome

Objective: The purpose of this study is to evaluate the effect of various upper extremity positions (adduction-abduction) on vascular structures in contrast-enhanced three-dimensional MR angiographic studies performed in patients with thoracic outlet syndrome. Materials and Methods: Twenty-two consecutive patients with clinical symptoms of neurovascular thoracic outlet syndrome were examined by 1.0 T MR unit. Examinations were studied by three-dimensional contrast-enhanced MR angiography with the arms positioned in abduction and adduction in the same patients. Results: In twenty-one of 44 subclavian arteries, impingement or stenosis with different degrees were found. Majority of lesions were localized in the costoclavicular region. Venous phase sequences of contrast-enhanced MR angiography showed compression of the subclavian vein in the 17 areas. Conclusion: Thoracic outlet syndrome remains controversial in both diagnosis and treatment, particulary in patients with no muscle atrophy, hand ischemia findings or venous stasis symptoms. Three-dimensional contrast-enhanced MR angiography is noninvasive and requires neither ionizing radia- tion nor administration of iodinated contrast material- and may be used to diagnose early compression findings and stenosis of the subclavian vessels.