Radiographic Imaging in Diagnosis and Assessment of NTOS

Chapter

Abstract

The clinical diagnosis of NTOS remains controversial and challenging. Fortunately, modern medical imaging, particularly MRI, provides excellent evaluation of the brachial plexus, the surrounding soft tissues and bones, and the dynamic changes that occur in the thoracic outlet on movement of the upper extremity. This chapter details the imaging anatomy of the thoracic outlet, including the component anatomic tunnels that comprise the thoracic outlet, the brachial plexus, and the dynamic changes of the thoracic outlet seen on movement of the upper extremity. Imaging findings of NTOS, as defined by pathologic entrapment of the brachial plexus, are demonstrated and defined, including soft tissue anomalies, bony anomalies, and pathologic dynamic changes that cause narrowing of the anatomic tunnels of the thoracic outlet and resultant entrapment of the brachial plexus. A simple and straightforward algorithm for reviewing an imaging study of a patient with TOS is provided. The reader will understand the important anatomic landmarks and tunnels of the thoracic outlet, the soft tissue or bony anomalies and pathologic changes that occur in the thoracic outlet, and the difference between normal and abnormal changes that occur on movement of the upper extremity, along with the resulting entrapment of the brachial plexus.

Keywords

Osteomyelitis Nephrotoxicity Exostosis 

References

  1. 1.
    Sanders RJ, Hammond SL, Rao NM. Thoracic outlet syndrome: a review. Neurologist. 2008;14(6):365–73.PubMedCrossRefGoogle Scholar
  2. 2.
    Brantigan CO, Roos DB. Diagnosing thoracic outlet syndrome. Hand Clin. 2004;20(1):27–36.PubMedCrossRefGoogle Scholar
  3. 3.
    Atasoy E. Thoracic outlet compression syndrome. Orthop Clin North Am. 1996;27(2):265–303.PubMedGoogle Scholar
  4. 4.
    Atasoy E. History of thoracic outlet syndrome. Hand Clin. 2004;20(1):15–6, v.PubMedCrossRefGoogle Scholar
  5. 5.
    Fugate M, Rotellini-Coltvet L, Freischlag J. Current management of thoracic outlet syndrome. Curr Treat Options Cardiovasc Med. 2009;11(2):176–83.PubMedCrossRefGoogle Scholar
  6. 6.
    Wilbourn AJ. The thoracic outlet syndrome is overdiagnosed. Arch Neurol. 1990;47(3):328–30.PubMedCrossRefGoogle Scholar
  7. 7.
    Roos DB. The thoracic outlet syndrome is underrated. Arch Neurol. 1990;47(3):327–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Wilbourn AJ. Thoracic outlet syndrome is overdiagnosed. Muscle Nerve. 1999;22(1):130–6, discussion 136–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Roos DB. Thoracic outlet syndrome is underdiagnosed. Muscle Nerve. 1999;22(1):126–9, discussion 137–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Plewa MC, Delinger M. The false-positive rate of thoracic outlet syndrome shoulder maneuvers in healthy subjects. Acad Emerg Med. 1998;5(4):337–42 (Official journal of the Society for Academic Emergency).PubMedCrossRefGoogle Scholar
  11. 11.
    Demirbag D, Unlu E, Ozdemir F, et al. The relationship between magnetic resonance imaging findings and postural maneuver and physical examination tests in patients with thoracic outlet syndrome: results of a double-blind, controlled study. Arch Phys Med Rehabil. 2007;88(7):844–51.PubMedCrossRefGoogle Scholar
  12. 12.
    Rayan GM. Thoracic outlet syndrome. J Shoulder Elbow Surg. 1998;7(4):440–51.PubMedCrossRefGoogle Scholar
  13. 13.
    Rayan G, Jensen C. Thoracic outlet syndrome: provocative examination maneuvers in a typical population. J Shoulder Elbow Surg. 1995;4:113–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Telford ED, Mottershead S. Pressure at the cervico-brachial junction. J Bone Joint Surg Br. 1948;30-B(2):249.Google Scholar
  15. 15.
    Remy-Jardin M, Doyen J, Remy J, Artaud D, Fribourg M, Duhamel A. Functional anatomy of the thoracic outlet: evaluation with spiral CT. Radiology. 1997;205(3):843–51.PubMedGoogle Scholar
  16. 16.
    Ranney D. Thoracic outlet: an anatomical redefinition that makes clinical sense. Clin Anat. 1996;9(1):50–2.PubMedCrossRefGoogle Scholar
  17. 17.
    Atasoy E. Thoracic outlet syndrome: anatomy. Hand Clin. 2004;20(1):7–14, v.PubMedCrossRefGoogle Scholar
  18. 18.
    Chiles C, Davis KW, Williams DW. Navigating the thoracic inlet. Radiographics. 1999;19(5):1161–76 (A review publication of the Radiological Society of North America, Inc.).PubMedGoogle Scholar
  19. 19.
    Rapoport S, Blair DN, McCarthy SM, Desser TS, Hammers LW, Sostman HD. Brachial plexus: correlation of MR imaging with CT and pathologic findings. Radiology. 1988;167(1):161–5.PubMedGoogle Scholar
  20. 20.
    Matsumura JS, Rilling WS, Pearce WH, Nemcek AA, Vogelzang RL, Yao JS. Helical computed tomography of the normal thoracic outlet. J Vasc Surg. 1997;26(5):776–83.PubMedCrossRefGoogle Scholar
  21. 21.
    Perlas A, Chan VWS, Simons M. Brachial plexus examination and localization using ultrasound and electrical stimulation: a volunteer study. Anesthesiology. 2003;99(2):429–35.PubMedCrossRefGoogle Scholar
  22. 22.
    Sheppard DG, Iyer RB, Fenstermacher MJ. Brachial plexus: demonstration at US. Radiology. 1998;208(2):402–6.PubMedGoogle Scholar
  23. 23.
    van Es HW, Bollen TL, van Heesewijk HPM. MRI of the brachial plexus: a pictorial review. Eur J Radiol. 2010;74(2):391–402.PubMedCrossRefGoogle Scholar
  24. 24.
    Van Es HW. MRI of the brachial plexus. Eur Radiol. 2001;11(2):325–36.PubMedCrossRefGoogle Scholar
  25. 25.
    Demondion X, Boutry N, Drizenko A, Paul C, Francke JP, Cotten A. Thoracic outlet: anatomic correlation with MR imaging. AJR Am J Roentgenol. 2000;175(2):417–22.PubMedCrossRefGoogle Scholar
  26. 26.
    Sherrier RH, Sostman HD. Magnetic resonance imaging of the brachial plexus. J Thorac Imaging. 1993;8(1):27–33.PubMedGoogle Scholar
  27. 27.
    Blair DN, Rapoport S, Sostman HD, Blair OC. Normal brachial plexus: MR imaging. Radiology. 1987;165(3):763–7.PubMedGoogle Scholar
  28. 28.
    Kellman GM, Kneeland JB, Middleton WD, et al. MR imaging of the supraclavicular region: normal anatomy. AJR Am J Roentgenol. 1987;148(1):77–82.PubMedCrossRefGoogle Scholar
  29. 29.
    Juvonen T, Satta J, Laitala P, Luukkonen K, Nissinen J. Anomalies at the thoracic outlet are frequent in the general population. Am J Surg. 1995;170(1):33–7.PubMedCrossRefGoogle Scholar
  30. 30.
    Kirgis HD, Reed AF. Significant anatomic relations in the syndrome of the scalene muscles. Ann Surg. 1948;127(6):1182–201.CrossRefGoogle Scholar
  31. 31.
    Gage M, Parnell H. Scalenusanticus syndrome. Am J Surg. 1947;73(2):252–68.PubMedCrossRefGoogle Scholar
  32. 32.
    Leinberry CF, Wehbé MA. Brachial plexus anatomy. Hand Clin. 2004;20(1):1–5.PubMedCrossRefGoogle Scholar
  33. 33.
    Bowen BC, Pattany PM, Saraf-Lavi E, Maravilla KR. The brachial plexus: normal anatomy, pathology, and MR imaging. Neuroimaging Clin N Am. 2004;14(1):59–85, vii–viii.PubMedCrossRefGoogle Scholar
  34. 34.
    Cooper A, Travers B. On exostosis. 3rd ed. 1821. p. 167–224.Google Scholar
  35. 35.
    Coote H. Exostosis of the left transverse process of the seventh cervical vertebra, surrounded by blood vessels and nerves-successful removal. Lancet. 1861;1:360–1.CrossRefGoogle Scholar
  36. 36.
    Todd TW. “Cervical Rib”: factors controlling its presence and its size. Its bearing on the morphology and development of the shoulder. J Anat Physiol. 1912;46(Pt 3):244–88.PubMedGoogle Scholar
  37. 37.
    Adson AW, Coffey JR. Cervical rib: a method of anterior approach for relief of symptoms by division of the scalenus anticus. Ann Surg. 1927;85(6):839.PubMedGoogle Scholar
  38. 38.
    Dow DR. The anatomy of rudimentary first thoracic ribs with special reference to the arrangement of the brachial plexus. J Anat. 1925;59(Pt 2):166.PubMedGoogle Scholar
  39. 39.
    Sabapathy SR, Venkatramani H, Bhardwaj P. Pseudarthrosis of cervical rib: an unusual cause of thoracic outlet syndrome. J Hand Surg Am. 2010;35(12):2018–21.PubMedCrossRefGoogle Scholar
  40. 40.
    Sanders RJ, Hammond SL. Management of cervical ribs and anomalous first ribs causing neurogenic thoracic outlet syndrome. J Vasc Surg. 2002;36(1):51–6.PubMedCrossRefGoogle Scholar
  41. 41.
    Criado E, Berguer R, Greenfield L. The spectrum of arterial compression at the thoracic outlet. J Vasc Surg. 2010;52(2):406–11.PubMedCrossRefGoogle Scholar
  42. 42.
    Gilliatt R, Le Quesne P, Logue V, Sumner AJ. Wasting of the hand associated with a cervical rib or band. Br Med J. 1970;33(5):615–24.Google Scholar
  43. 43.
    Roos DB. Experience with first rib resection for thoracic outlet syndrome. Ann Surg. 1971;173(3):429–42.PubMedCrossRefGoogle Scholar
  44. 44.
    Roos D. Congenital anomalies associated with thoracic outlet syndrome: anatomy, symptoms, diagnosis, and treatment. Am J Surg. 1976;132(6):771–8.PubMedCrossRefGoogle Scholar
  45. 45.
    Terabayashi N, Ohno T, Nishimoto Y, et al. Nonunion of a first rib fracture causing thoracic outlet syndrome in a basketball player: a case report. J Shoulder Elbow Surg. 2010;19(6):e20–3.PubMedCrossRefGoogle Scholar
  46. 46.
    Panegyres P, Moore N, Gibson R. Thoracic outlet syndromes and magnetic resonance imaging. Brain. 1993;116(Pt 4):823–41.PubMedCrossRefGoogle Scholar
  47. 47.
    O’Brien PJ, Ramasunder S, Cox MW. Venous thoracic outlet syndrome secondary to first rib osteochondroma in a pediatric patient. J Vasc Surg. 2011;53(3):811–3.PubMedCrossRefGoogle Scholar
  48. 48.
    Yeow KM, Hsieh HC. Thoracic outlet syndrome caused by first rib hemangioma. J Vasc Surg. 2001;33(5):1118–21.PubMedCrossRefGoogle Scholar
  49. 49.
    Haniuda M, Morimoto M, Nishimura H. A case of chondrosarcoma arising from the left first rib. Kyobu Geka. 1990;43(10):835–8 (The Japanese journal of thoracic surgery).PubMedGoogle Scholar
  50. 50.
    Nehme A, Tricoire J, Giordano G, Rouge D, Chiron P, Puget J. Coracoclavicular joints. Reflections upon incidence, pathophysiology and etiology of the different forms. Surg Radiol Anat. 2004;26(1):33–8.PubMedCrossRefGoogle Scholar
  51. 51.
    Hama H, Matsusue Y, Ito H, Yamamuro T. Thoracic outlet syndrome associated with an anomalous coracoclavicular joint. A case report. J Bone Joint Surg Am. 1993;75(9):1368–9.PubMedGoogle Scholar
  52. 52.
    Khu KJ, Midha R. Clavicle pseudarthrosis: a rare cause of thoracic outlet syndrome. Can J Neurol Sci. 2010;37(6):863–5.PubMedGoogle Scholar
  53. 53.
    Bilbey JH, Lamond RG, Mattrey RF. MR imaging of disorders of the brachial plexus. J Magn Reson Imaging. 1994;4(1):13–8.PubMedCrossRefGoogle Scholar
  54. 54.
    Kitsis CK, Marino AJ, Krikler SJ, Birch R. Late complications following clavicular fractures and their operative management. Injury. 2003;34(1):69–74.PubMedCrossRefGoogle Scholar
  55. 55.
    Jain S, Monbaliu D, Thompson JF. Thoracic outlet syndrome caused by chronic retrosternal dislocation of the clavicle. Successful treatment by transaxillary resection of the first rib. J Bone Joint Surg Br. 2002;84(1):116–8.PubMedCrossRefGoogle Scholar
  56. 56.
    Kapickis M. Neurogenic thoracic outlet syndrome caused by subacute clavicle osteomyelitis. Acta Chir Latviensis. 2011;10(2):124–6.Google Scholar
  57. 57.
    Durham JR, Yao JS, Pearce WH, Nuber GM, McCarthy WJ. Arterial injuries in the thoracic outlet syndrome. J Vasc Surg. 1995;21(1):57–69, discussion 70.PubMedCrossRefGoogle Scholar
  58. 58.
    Todd TW. The relations of the thoracic operculum considered in reference to the anatomy of cervical ribs of surgical importance. J Anat Physiol. 1911;45(Pt 3):293–304.PubMedGoogle Scholar
  59. 59.
    Stopford JSB, Telford ED. Compression of the lower trunk of the brachial plexus by a first dorsal rib. With a note on the surgical treatment. Br J Surg. 1919;7(26):168–77.CrossRefGoogle Scholar
  60. 60.
    Brickner W. Brachial plexus pressure by the normal first rib. Ann Surg. 1927;85(6):858–72.PubMedGoogle Scholar
  61. 61.
    Murphy T. Brachial neuritis caused by pressure of first rib. Aust Med J. 1910;15:582–5.Google Scholar
  62. 62.
    Ochsner A, Gage M. Scalenusanticus (Naffziger) syndrome. Am J Surg. 1935;28:669.CrossRefGoogle Scholar
  63. 63.
    Swank RL, Simeone FA. The scalenus anticus syndrome: types, their characterization, diagnosis and treatment. Arch Neurol Psychiatry. 1944;51(5):432.CrossRefGoogle Scholar
  64. 64.
    Roos D. New concepts of thoracic outlet syndrome that explain etiology, symptoms, diagnosis, and treatment. Vasc Endovascular Surg. 1979;13(5):313–21.CrossRefGoogle Scholar
  65. 65.
    Roos DB. Pathophysiology of congenital anomalies in thoracic outlet syndrome. Acta Chir Belg. 1980;79(5):353–61.PubMedGoogle Scholar
  66. 66.
    Lindgren SH, Ribbe EB, Norgren LE. Two year follow-up of patients operated on for thoracic outlet syndrome. Effects on sick-leave incidence. Eur J Vasc Surg. 1989;3(5):411–5.PubMedCrossRefGoogle Scholar
  67. 67.
    Law AA. Adventitious ligaments simulating cervical ribs. Ann Surg. 1920;72(4):497.PubMedCrossRefGoogle Scholar
  68. 68.
    Gaughran GRL. Suprapleural membrane and suprapleural bands. Anat Rec. 1964;148(4):553–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Poitevin L. Proximal compressions of the upper limb neurovascular bundle. An anatomic research study. Hand Clin. 1988;4(4):575–84.PubMedGoogle Scholar
  70. 70.
    Makhoul RG, Machleder HI. Developmental anomalies at the thoracic outlet: an analysis of 200 consecutive cases. J Vasc Surg. 1992;16(4):534–42, discussion 542–5.PubMedCrossRefGoogle Scholar
  71. 71.
    Harry W, Bennett J, Guha S. Scalene muscles and the brachial plexus: anatomical variations and their clinical significance. Clin Anat. 1997;10(4):250–2.PubMedCrossRefGoogle Scholar
  72. 72.
    Paraskevas G, Ioannidis O, Papaziogas B, Natsis K, Spanidou S, Kitsoulis P. An accessory middle scalene muscle causing thoracic outlet syndrome. Folia Morphol (Warsz). 2007;66(3):194–7.Google Scholar
  73. 73.
    Hug U, Burg D, Meyer V. Cervical outlet syndrome due to an accessory part of the trapezius muscle in the posterior triangle of the neck. J Hand Surg Eur Vol. 2000;25(3):311–3.CrossRefGoogle Scholar
  74. 74.
    O’Sullivan ST, Kay SP. An unusual variant of the levator claviculae muscle encountered in exploration of the brachial plexus. J Hand Surg Br. 1998;23(1):134–5.PubMedCrossRefGoogle Scholar
  75. 75.
    Darwish H, Ibrahim A. Three muscles in the upper costovertebral region: description and clinical anatomy. Clin Anat. 2009;22(3):352–7. doi: 10.1002/ca.20773.PubMedCrossRefGoogle Scholar
  76. 76.
    Rajanigandha V, Ranade A, Pai M, Rai R, Prabhu L, Nayak S. The scalenus accessorious muscle. Int J Morph. 2008;26(2):385–8.Google Scholar
  77. 77.
    Goubran E, Carlos J, Ayad S. A bifurcated anterior scalene muscle: a case report. Clin Chiropr. 2010;13(2):153–5.CrossRefGoogle Scholar
  78. 78.
    Cooke R. Thoracic outlet syndrome-aspects of diagnosis in the differential diagnosis of hand-arm vibration syndrome. Occup Med. 2003;53(5):331–6.CrossRefGoogle Scholar
  79. 79.
    Lee J, Laker S, Fredericson M. Thoracic outlet syndrome. PM R. 2010;2(1):64–70.PubMedCrossRefGoogle Scholar
  80. 80.
    Safran MR. Nerve injury about the shoulder in athletes, part 2: long thoracic nerve, spinal accessory nerve, burners/stingers, thoracic outlet syndrome. Am J Sports Med. 2004;32(4):1063–76.PubMedCrossRefGoogle Scholar
  81. 81.
    Esposito MD, Arrington JA, Blackshear MN, Murtagh FR, Silbiger ML. Thoracic outlet syndrome in a throwing athlete diagnosed with MRI and MRA. J Magn Reson Imaging. 1997;7(3):598–9.PubMedCrossRefGoogle Scholar
  82. 82.
    Rayan G. Lower trunk brachial plexus compression neuropathy due to cervical rib in young athletes. Am J Sports Med. 1988;16(1):77–9.PubMedCrossRefGoogle Scholar
  83. 83.
    Machleder HI, Moll F, Verity MA. The anterior scalene muscle in thoracic outlet compression syndrome. Histochemical and morphometric studies. Arch Surg. 1986;121(10):1141–4.PubMedCrossRefGoogle Scholar
  84. 84.
    Sanders RJ, Ratzin Jackson CG, Banchero N, Pearce WH. Scalene muscle abnormalities in traumatic thoracic outlet syndrome. Am J Surg. 1990;159(2):231–6.PubMedCrossRefGoogle Scholar
  85. 85.
    Ozçakar L, Güney MS, Ozdağ F, et al. A sledgehammer on the brachial plexus: thoracic outlet syndrome, subclavius posticus muscle, and traction in aggregate. Arch Phys Med Rehabil. 2010;91(4):656–8.PubMedCrossRefGoogle Scholar
  86. 86.
    Akita K, Ibukuro K, Yamaguchi K, Heima S, Sato T. The subclavius posticus muscle: a factor in arterial, venous or brachial plexus compression. Surg Radiol Anat. 2000;22(2):111–5.PubMedCrossRefGoogle Scholar
  87. 87.
    Thompson JF, Winterborn RJ, Bays S, White H, Kinsella DC, Watkinson AF. Venous thoracic outlet compression and the paget-schroetter syndrome: a review and recommendations for management. Cardiovasc Intervent Radiol. 2011;34(5):903–10.PubMedCrossRefGoogle Scholar
  88. 88.
    Demondion X, Bacqueville E, Paul C, Duquesnoy B, Hachulla E, Cotten A. Thoracic outlet: assessment with MR imaging in asymptomatic and symptomatic populations. Radiology. 2003;227(2):461–8.PubMedCrossRefGoogle Scholar
  89. 89.
    Turgut H, Anil A, Peker T, Barut C. Insertion abnormality of bilateral pectoralis minimus. Surg Radiol Anat. 2000;22(1):55–7.PubMedCrossRefGoogle Scholar
  90. 90.
    Clarys J, Barbaix E, Vanrompaey H, Caboor D, Vanroy P. The muscular arch of the axilla revisited: its possible role in the thoracic outlet and shoulder instability syndromes. Man Ther. 1996;1(3):133–9.PubMedCrossRefGoogle Scholar
  91. 91.
    Duwayri YM, Emery VB, Driskill MR, et al. Positional compression of the axillary artery causing upper extremity thrombosis and embolism in the elite overhead throwing athlete. J Vasc Surg. 2011;53(5):1329–40.PubMedCrossRefGoogle Scholar
  92. 92.
    Ikezawa T, Iwatsuka Y, Asano M, Kimura A, Sasamoto A, Ono Y. Upper extremity ischemia in athletes: embolism from the injured posterior circumflex humeral artery. Int J Angiol. 2000;9(3):138–40.CrossRefGoogle Scholar
  93. 93.
    Gelabert HA, Machleder HI. Diagnosis and management of arterial compression at the thoracic outlet. Ann Vasc Surg. 1997;11(4):359–66.PubMedCrossRefGoogle Scholar
  94. 94.
    Uysal II, Seker M, Karabulut AK, Büyükmumcu M, Ziylan T. Brachial plexus variations in human fetuses. Neurosurgery. 2003;53(3):676–84, discussion 684.PubMedCrossRefGoogle Scholar
  95. 95.
    Natsis K, Totlis T, Tsikaras P, Anastasopoulos N, Skandalakis P, Koebke J. Variations of the course of the upper trunk of the brachial plexus and their clinical significance for the thoracic outlet syndrome: a study on 93 cadavers. Am Surg. 2006;72(2):188–92.PubMedGoogle Scholar
  96. 96.
    Pellerin M, Kimball Z, Tubbs RS, et al. The prefixed and postfixed brachial plexus: a review with surgical implications. Surg Radiol Anat. 2010;32(3):251–60.PubMedCrossRefGoogle Scholar
  97. 97.
    Lindgren K, Manninen H, Rytkönen H. Case of the month. Thoracic outlet syndrome-a functional disturbance of the thoracic upper aperture? Muscle Nerve. 1995. doi: 10.1002/mus.880180508.
  98. 98.
    Remy-Jardin M, Remy J, Masson P, et al. CT angiography of thoracic outlet syndrome: evaluation of imaging protocols for the detection of arterial stenosis. J Comput Assist Tomogr. 2000;24(3):349.PubMedCrossRefGoogle Scholar
  99. 99.
    Gillard J, Pérez-Cousin M, Hachulla E, et al. Diagnosing thoracic outlet syndrome: contribution of provocative tests, ultrasonography, electrophysiology, and helical computed tomography in 48 patients. Joint Bone Spine. 2001;68(5):416–24.PubMedCrossRefGoogle Scholar
  100. 100.
    Demondion X, Herbinet P, van Sint Jan S, Boutry N, Chantelot C, Cotten A. Imaging assessment of thoracic outlet syndrome. Radiographics. 2006;26(6):1735–50 (A review publication of the Radiological Society of North America, Inc.).PubMedCrossRefGoogle Scholar
  101. 101.
    Nord KM, Kapoor P, Fisher J, et al. False positive rate of thoracic outlet syndrome diagnostic maneuvers. Electromyogr Clin Neurophysiol. 2008;48(2):67–74.PubMedGoogle Scholar
  102. 102.
    Ozçakar L, Dönmez G, Yörübulut M, et al. Paget-schroetter syndrome forerunning the diagnosis of thoracic outlet syndrome and thrombophilia. Clin Appl Thromb Hemost. 2010;16(3):351–5.PubMedCrossRefGoogle Scholar
  103. 103.
    Laban MM, Zierenberg AT, Yadavalli S, Zaidan S. Clavicle-induced narrowing of the thoracic outlet during shoulder abduction as imaged by computed tomographic angiography and enhanced by three-dimensional reformation. Am J Phys Med Rehabil. 2011;90(7):572–8.PubMedCrossRefGoogle Scholar
  104. 104.
    Remy-Jardin M, Remy J, Masson P, et al. Helical CT angiography of thoracic outlet syndrome: functional anatomy. AJR Am J Roentgenol. 2000;174(6):1667–74.PubMedCrossRefGoogle Scholar
  105. 105.
    Brantigan CO, Johnston RJ, Roos DB. Appendix: use of multidetector CT and three-dimensional reconstructions in thoracic outlet syndrome: a preliminary report. Hand Clin. 2004;20(1):123–6, viii.PubMedCrossRefGoogle Scholar
  106. 106.
    Bilbey JH, Müller NL, Connell DG, Luoma AA, Nelems B. Thoracic outlet syndrome: evaluation with CT. Radiology. 1989;171(2):381–4.PubMedGoogle Scholar
  107. 107.
    Longley DG, Yedlicka JW, Molina EJ, Schwabacher S, Hunter DW, Letourneau JG. Thoracic outlet syndrome: evaluation of the subclavian vessels by color duplex sonography. AJR Am J Roentgenol. 1992;158(3):623–30.PubMedCrossRefGoogle Scholar
  108. 108.
    Odderson IR, Chun ES, Kolokythas O, Zierler RE. Use of sonography in thoracic outlet syndrome due to a dystonic pectoralis minor. J Ultrasound Med. 2009;28(9):1235–8 (Official journal of the American Institute of Ultrasound in Medicine).PubMedGoogle Scholar
  109. 109.
    Vargas MI, Viallon M, Nguyen D, Beaulieu JY, Delavelle J, Becker M. New approaches in imaging of the brachial plexus. Eur J Radiol. 2010;74(2):403–10.PubMedCrossRefGoogle Scholar
  110. 110.
    Chin C. Magnetic resonance neurography. In: Nerve and vascular injuries in sports medicine. New York: Springer; 2009. p. 27–39.CrossRefGoogle Scholar
  111. 111.
    Filler A. MR Neurography and diffusion tensor imaging: origins, history and clinical impact of the first 50,000 cases with an assessment of efficacy and utility in a prospective 5,000 patient study group. Neurosurgery 2009;65(Suppl 4):A29.Google Scholar
  112. 112.
    Filler A, Maravilla K, Tsuruda J. MR neurography and muscle MR imaging for image diagnosis of disorders affecting the peripheral nerves and musculature. Neurol Clin. 2004;22(3):643–82.PubMedCrossRefGoogle Scholar
  113. 113.
    van Es H. MR imaging of the brachial plexus. Utrecht: University Hospital; 1997.Google Scholar
  114. 114.
    Es HW, Witkamp TD, Feldberg MAM. MRI of the brachial plexus and its region: anatomy and pathology. Eur Radiol. 1995;5(2):145–51.CrossRefGoogle Scholar
  115. 115.
    Filler A. MR neurography and brachial plexus neurolysis in the management of thoracic outlet syndromes. In: Yao J, Pearce W, editors. Advances in vascular surgery. 2002. p. 499–523.Google Scholar
  116. 116.
    Maravilla K, Bowen B. Imaging of the peripheral nervous system: evaluation of peripheral neuropathy and plexopathy. AJNR Am J Neuroradiol. 1998;19(6):1011–23.PubMedGoogle Scholar
  117. 117.
    Demondion X, Herbinet P, Boutry N, Fontaine C, Francke J-P, Cotten A. Sonographic mapping of the normal brachial plexus. American Journal of Neuroradiology 2003;24(7):1303–9.PubMedGoogle Scholar

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© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Vanguard Specialty ImagingSunnyvaleUSA

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