lMayo Clinic, Rochester, Minnesota. mUniversity of Virginia, Charlottesville, Virginia. nUniversity of California Los Angeles, Los Angeles, California; American Academy of Neurology. oVanderbilt University Medical Center, Nashville, Tennessee; American College of Chest Physicians. pLoyola University Medical Center, Maywood, Illinois. qUT Southwestern Medical Center, Dallas, Texas. rDuke University School of Medicine, Durham, North Carolina; The Society of Thoracic Surgeons. sUT Southwestern Medical Center, Dallas, Texas. tSpecialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia. uSpecialty Chair, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. vSpecialty Chair, UMass Memorial Medical Center, Worcester, Massachusetts. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Thoracic Outlet Syndrome with a radiologist may be useful at the time of examination ordering to optimize the study for the prevailing clinical symptom. When contrast is indicated, scan acquisition is typically performed with a contralateral antecubital intravenous (IV) injection, with either an empiric scan delay of 15 to 20 seconds or bolus tracking over the ascending aorta [12,13]. Some centers add the additional step of placing the contralateral arm in abduction (with the symptomatic ipsilateral arm in the neutral position) in order to minimize streak artifact [14]. All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and recons/reformats. Only in CTA, however, is 3-D rendering a required element.
Thoracic Outlet Syndrome. lMayo Clinic, Rochester, Minnesota. mUniversity of Virginia, Charlottesville, Virginia. nUniversity of California Los Angeles, Los Angeles, California; American Academy of Neurology. oVanderbilt University Medical Center, Nashville, Tennessee; American College of Chest Physicians. pLoyola University Medical Center, Maywood, Illinois. qUT Southwestern Medical Center, Dallas, Texas. rDuke University School of Medicine, Durham, North Carolina; The Society of Thoracic Surgeons. sUT Southwestern Medical Center, Dallas, Texas. tSpecialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia. uSpecialty Chair, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. vSpecialty Chair, UMass Memorial Medical Center, Worcester, Massachusetts. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Thoracic Outlet Syndrome with a radiologist may be useful at the time of examination ordering to optimize the study for the prevailing clinical symptom. When contrast is indicated, scan acquisition is typically performed with a contralateral antecubital intravenous (IV) injection, with either an empiric scan delay of 15 to 20 seconds or bolus tracking over the ascending aorta [12,13]. Some centers add the additional step of placing the contralateral arm in abduction (with the symptomatic ipsilateral arm in the neutral position) in order to minimize streak artifact [14]. All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and recons/reformats. Only in CTA, however, is 3-D rendering a required element.