CT Chest CT for the evaluation of nTOS is limited by the lack of resolution of neural structures, although evaluation of the space sizes gives secondary indicators that may aid in diagnosis [13]. The goal is to demonstrate anatomical narrowing that could cause neurovascular compression. Findings include effacement of fat within the respective space and distortion or narrowing of the space with provocative or stress positioning. To also define adjacent vascular structures, a CT with IV contrast is sufficient for evaluation of nTOS [12,13]. CT allows quantification of the change in costoclavicular or interscalene spaces with provocative maneuvers [12,13], the presence of bony abnormalities [20,21], or superior sulcus pathology [22]. CT without IV contrast may be performed in the postintervention setting to evaluate interval changes in the thoracic outlet and assess adequate decompression. If there is a clinical concern for arterial or venous compromise, postintervention for patients with nTOS, imaging should be guided by those Variants. CTA Chest CTA does not provide further evaluation of the neurologic structures as compared with chest CT. If there are overlapping symptoms with aTOS or vTOS, review of the other Variants in this document may help with protocol optimization. CTV Chest CTV does not provide further evaluation of the neurologic structures as compared with chest CT. If there are overlapping symptoms, review of the other Variants in this document may help with protocol optimization. MRI Chest MRI has inherent advantages over ultrasound (US) in its ability to delineate extravascular anatomy, particularly in anatomic sites with poor sonographic windows, and MRI has advantages over CT in its characterization and differentiation of soft tissues. Thoracic Outlet Syndrome
Thoracic Outlet Syndrome. CT Chest CT for the evaluation of nTOS is limited by the lack of resolution of neural structures, although evaluation of the space sizes gives secondary indicators that may aid in diagnosis [13]. The goal is to demonstrate anatomical narrowing that could cause neurovascular compression. Findings include effacement of fat within the respective space and distortion or narrowing of the space with provocative or stress positioning. To also define adjacent vascular structures, a CT with IV contrast is sufficient for evaluation of nTOS [12,13]. CT allows quantification of the change in costoclavicular or interscalene spaces with provocative maneuvers [12,13], the presence of bony abnormalities [20,21], or superior sulcus pathology [22]. CT without IV contrast may be performed in the postintervention setting to evaluate interval changes in the thoracic outlet and assess adequate decompression. If there is a clinical concern for arterial or venous compromise, postintervention for patients with nTOS, imaging should be guided by those Variants. CTA Chest CTA does not provide further evaluation of the neurologic structures as compared with chest CT. If there are overlapping symptoms with aTOS or vTOS, review of the other Variants in this document may help with protocol optimization. CTV Chest CTV does not provide further evaluation of the neurologic structures as compared with chest CT. If there are overlapping symptoms, review of the other Variants in this document may help with protocol optimization. MRI Chest MRI has inherent advantages over ultrasound (US) in its ability to delineate extravascular anatomy, particularly in anatomic sites with poor sonographic windows, and MRI has advantages over CT in its characterization and differentiation of soft tissues. Thoracic Outlet Syndrome