Imaging Assessment of Vascular Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a complex symptom consisting of neural, arterial, and venous disorders of the upper extremity. These are caused by compression of the neurovascular structures between the clavicle and first rib in the thoracic outlet (TO). Diagnosis of TOS is difficult . Bony abnormalities are present in approximately 30 of patients with TOS, either as a cervical rib, a bifid first rib, fusion of the first rib and second ribs, clavicular deformities or previous thoracoplasty. These bone abnormalities can be better evaluated with a 3D-CT scan than direct cervical radiograms. In addition, the cervical ribs, their length, and their attachment zone in the first ribs are easily analyzed with 3D-CT.