Clinical Significance of Maximum Intensity Projection Method for Diagnostic Imaging of Thoracic Outlet Syndrome

Takeshi Ogawa; Shinzo Onishi; Naotaka Mamizuka; Yuichi Yoshii; Kazuhiro Ikeda; Takeo Mammoto; Masashi Yamazaki

doi:10.3390/diagnostics13020319

Clinical Significance of Maximum Intensity Projection Method for Diagnostic Imaging of Thoracic Outlet Syndrome

Diagnostics (Basel). 2023 Jan 15;13(2):319. doi: 10.3390/diagnostics13020319.

Authors

Takeshi Ogawa^{1

2}, Shinzo Onishi^{2

3}, Naotaka Mamizuka⁴, Yuichi Yoshii⁵, Kazuhiro Ikeda⁶, Takeo Mammoto², Masashi Yamazaki³

Affiliations

¹ Department of Orthopedic Surgery, National Hospital Organization Mito Medical Center, 280 Sakuranosato, Ibarakimachi 311-3193, Japan.
² Department of Orthopedic Surgery and Sports Medicine, Mito Clinical Education and Training Center, University of Tsukuba Hospital, Mito Kyodo General Hospital, 3-2-7 Miya-Machi, Mito 310-0015, Japan.
³ Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan.
⁴ Baseball and Sports Clinic, 2-228-1 Kosugi, Park City Musashikosugi the Garden Towers West 1st Floor W4, Nakahara-Ward, Kawasaki 211-0063, Japan.
⁵ Department of Orthopedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami 300-0395, Japan.
⁶ Department of Orthopedic Surgery, Kikkoman General Hospital, Noda 278-0005, Japan.

Abstract

The aim of this study was to use the magnetic resonance imaging maximum-intensity projection (MRI-MIP) method for diagnostic imaging of thoracic outlet syndrome (TOS) and to investigate the stricture ratios of the subclavian artery (SCA), subclavian vein (SCV), and brachial plexus bundle (BP). A total of 113 patients with clinically suspected TOS were evaluated. MRI was performed in a position similar to the Wright test. The stricture was classified into four grades. Then, the stricture ratios of the SCA, SCV, and BP in the sagittal view were calculated by dividing the minimum diameter by the maximum diameter of each structure. Patients were divided into two groups: surgical (n = 22) and conservative (n = 91). Statistical analysis was performed using the Mann-Whitney U test. The stricture level and ratio in the SCV were significantly higher in the surgical group, while the stricture level and the ratio of SCA to BP did not show significant differences between the two groups. The MRI-MIP method may be helpful for both subsidiary and severe diagnoses of TOS.

Keywords: maximum intensity projection; subclavian vein; thoracic outlet syndrome.

Grants and funding

This research received no external funding.