A Novel Approach for Imaging of Thoracic Outlet Syndrome Using Contrast-Enhanced Magnetic Resonance Angiography (CE-MRA), Short Inversion Time Inversion Recovery Sampling Perfection with Application-Optimized Contrasts Using Different Flip Angle Evolutions (T2-STIR-SPACE), and Volumetric Interpolated Breath-Hold Examination (VIBE)
| Autor: | Jianxin Chen, Zongbao Liu, Zhengdao Xu, Liping Shen, Yijiang Hu, Tao Wang, Tonghua Zhang, Feifei Xue |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Contrast Media 030204 cardiovascular system & hematology Magnetic resonance angiography Breath Holding 03 medical and health sciences 0302 clinical medicine Flip angle Clinical Research medicine.artery medicine Humans Brachial Plexus Subclavian artery Thoracic outlet syndrome Aged medicine.diagnostic_test Cervical rib business.industry Nerve Compression Syndromes Magnetic resonance imaging General Medicine medicine.disease Neurovascular bundle Magnetic Resonance Imaging Thoracic Outlet Syndrome 030220 oncology & carcinogenesis cardiovascular system Female business Nuclear medicine Brachial plexus Magnetic Resonance Angiography Neurilemmoma |
| Zdroj: | Medical Science Monitor : International Medical Journal of Experimental and Clinical Research |
| ISSN: | 1643-3750 |
| Popis: | BACKGROUND The aim of this study was to introduce a novel method combining contrast-enhanced magnetic resonance angiography (CE-MRA), short inversion time inversion recovery sampling perfection with application-optimized contrasts using different flip angle evolutions (T2-STIR-SPACE) and volumetric interpolated breath-hold examination (VIBE) sequences in the assessment of thoracic outlet syndrome (TOS). MATERIAL AND METHODS CE-MRA, T2-STIR-SPACE, and VIBE techniques were employed to evaluate neurovascular bundles in 27 patients clinically suspected of TOS. Images were evaluated to determine the cause of neurovascular bundle compression. Surgical exploration was performed in patients with abnormal magnetic resonance imaging (MRI) results. RESULTS Twenty patients were found to be abnormal: 6 cases showed only neurogenic TOS and the correlates included infraclavicular hemangiomas (n=1) and transverse cervical artery (n=5). Arterial-neurogenic TOS was found in 4 cases, including subclavian lymph node metastasis from breast cancer (n=3) and schwannoma (n=1). Arterial-venous-neurogenic TOS was found in 1 subject, and the correlates included a fibrous band from the cervical rib and elongated C7 transverse process. In this case, the subclavian artery/vein was compressed dynamically. Venous-neurogenic TOS was noted in one subject. Nine patients were considered as post-traumatic TOS, including brachial plexus edema (n=3), the brachial plexus rupture (n=2), peri-brachial plexus effusion (n=3), and stenosis of the SCA (n=1). In the remaining 7 patients, MRI did not detect abnormalities. CONCLUSIONS TOS can be evaluated by CE-MRA, T2-STIR-SPACE, and VIBE during a single examination, with a reduced contrast material dose. This imaging modality performs well in showing the anatomical structure of the neurovascular bundle and the cause of the compression. |
| Databáze: | OpenAIRE |
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