ACR Appropriateness Criteria Imaging in the Diagnosis of Thoracic Outlet Syndrome

John M Moriarty; Dennis F Bandyk; Daniel F Broderick; Rebecca S Cornelius; Karin E Dill; Christopher J Francois; Marie D Gerhard-Herman; Mark E Ginsburg; Michael Hanley; Sanjeeva P Kalva; Jeffrey P Kanne; Loren H Ketai; Bill S Majdalany; James G Ravenel; Christopher J Roth; Anthony G Saleh; Matthew P Schenker; Tan-Lucien H Mohammed; Frank J Rybicki

doi:10.1016/j.jacr.2015.01.016

ACR Appropriateness Criteria Imaging in the Diagnosis of Thoracic Outlet Syndrome

J Am Coll Radiol. 2015 May;12(5):438-43. doi: 10.1016/j.jacr.2015.01.016. Epub 2015 Mar 29.

Authors

John M Moriarty¹, Dennis F Bandyk², Daniel F Broderick³, Rebecca S Cornelius⁴, Karin E Dill⁵, Christopher J Francois⁶, Marie D Gerhard-Herman⁷, Mark E Ginsburg⁸, Michael Hanley⁹, Sanjeeva P Kalva¹⁰, Jeffrey P Kanne¹¹, Loren H Ketai¹², Bill S Majdalany¹³, James G Ravenel¹⁴, Christopher J Roth¹⁵, Anthony G Saleh¹⁶, Matthew P Schenker¹⁷, Tan-Lucien H Mohammed¹⁸, Frank J Rybicki¹⁷

Affiliations

¹ University of California Los Angeles, Los Angeles, California. Electronic address: jmoriarty@mednet.ucla.edu.
² University of California San Diego, La Jolla, California; Society for Vascular Surgery, Chicago, Illinois.
³ Mayo Clinic Jacksonville, Jacksonville, Florida.
⁴ University of Cincinnati, Cincinnati, Ohio.
⁵ University of Chicago, Chicago, Illinois.
⁶ University of Wisconsin, Madison, Wisconsin.
⁷ Brigham and Women's Hospital, Boston, Massachusetts; American College of Cardiology, Washington, DC.
⁸ Columbia University, New York, New York; Society of Thoracic Surgeons, Washington, DC.
⁹ University of Virginia, Charlottesville, Virginia.
¹⁰ University of Texas Southwestern Medical Center, Dallas, Texas.
¹¹ University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
¹² University of New Mexico, Albuquerque, New Mexico.
¹³ Ohio State University Hospital, Columbus, Ohio.
¹⁴ Medical University of South Carolina, Charleston, South Carolina.
¹⁵ Duke University Medical Center, Durham, North Carolina.
¹⁶ New York Methodist Hospital, Brooklyn, New York; The American College of Chest Physicians, Northbrook, IL.
¹⁷ Brigham and Women's Hospital, Boston, Massachusetts.
¹⁸ University of Florida College of Medicine, Gainesville, Florida.

PMID: 25824254
DOI: 10.1016/j.jacr.2015.01.016

Abstract

Thoracic outlet syndrome is a clinical entity characterized by compression of the neurovascular bundle, and may be associated with additional findings such as venous thrombosis, arterial stenosis, or neurologic symptoms. The goal of imaging is to localize the site of compression, the compressing structure, and the compressed organ or vessel, while excluding common mimics. A literature review is provided of current indications for diagnostic imaging, with discussion of potential limitations and benefits of the respective modalities. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. In this document, we provided guidelines for use of various imaging modalities for assessment of thoracic outlet syndrome.

Keywords: Appropriateness criteria; Paget-Schroetter; thoracic outlet.

Publication types

Review

MeSH terms

Diagnostic Imaging / standards*
Humans
Practice Guidelines as Topic*
Radiology / standards*
Societies, Medical*
Thoracic Outlet Syndrome / diagnosis*
United States