Department of Thoracic Surgery, Lokman Hekim University Hospital, Ankara, Turkey
Department of Anatomy, Ankara University School of Medicine, Ankara, Turkey
Turk J Med Sci. 2021 Aug 30;51(4):1849-1856. doi: 10.3906/sag-2101-375.
BACKGROUND/AIM: The aim of this study was to measure the volume of interscalene space in thoracic outlet region on cadavers and radiological images and to analyze the potential value of these measurements in diagnosis and treatment of thoracic outlet syndrome (TOS).
The dimensions of the anterior interscalene space in 8 formalin-fixed human cadavers were studied by direct measurement and additionally evaluation of the volume of this space were done by using mold and volume calculation formula of square pyramid, due to resembling a pyramid. In the second phase of this study, interscalene space volume was calculated by formula and compared to calculations from computed tomography (CT) sections in 18 TOS and 16 control patients.
There was a strong correlation between the volume calculated by formula (4.79 ± 2.18 cm3) and by mold (4.84 ± 1.58 cm3), (R = 0.934, p = 0.001) in cadavers. The average volume measured in TOS patients (2.05 ± 0.32 cm3) was significantly smaller than control patients (4.30 ± 1.85 cm3, p < 0.0001). There were excellent or good results in 14 patients whereas in 4 patients who had neurogenic TOS achieved fair results after surgery. In these 4 patients the average volumes of abnormal sides were close to the healthy sides.
In our study, volume of interscalene space in TOS patients was statistically smaller than control group. Also, the volume was even smaller in patients with excellent or good results after surgery. In this respect, volumetric measurements from CT sections could be used in diagnosis and treatment selection in TOS patients.
背景/目的：本研究旨在测量尸检和影像学图像中胸廓出口区斜角肌间隙的体积，并分析这些测量值在胸廓出口综合征（TOS）的诊断和治疗中的潜在价值。
通过直接测量，研究了 8 例福尔马林固定人体尸体的前斜角肌间隙的尺寸，并且由于类似于金字塔，使用模具和方棱锥体积计算公式对该空间的体积进行了额外评估。在本研究的第二阶段，通过公式计算了斜角肌间隙的体积，并将其与 18 例 TOS 和 16 例对照组患者的 CT 切片计算结果进行了比较。
在尸体中，公式计算的体积（4.79 ± 2.18 cm3）与模具测量的体积（4.84 ± 1.58 cm3）之间存在很强的相关性（R = 0.934，p = 0.001）。TOS 患者的平均体积（2.05 ± 0.32 cm3）明显小于对照组患者（4.30 ± 1.85 cm3，p < 0.0001）。14 例患者取得了良好或优秀的结果，而 4 例患有神经性 TOS 的患者在手术后取得了中等的结果。在这 4 例患者中，异常侧的平均体积接近健康侧。
在我们的研究中，TOS 患者的斜角肌间隙体积明显小于对照组。此外，手术后取得良好或优秀结果的患者的体积甚至更小。在这方面，CT 切片的体积测量值可用于 TOS 患者的诊断和治疗选择。
