Emory University, Atlanta, GA, United States of America.
Department of Radiology, University of Washington School of Medicine, Seattle, WA, United States of America.
Clin Imaging. 2022 Sep;89:23-36. doi: 10.1016/j.clinimag.2022.06.003. Epub 2022 Jun 8.
Thoracic outlet syndrome (TOS) is a clinical disorder resulting from compression of the neurovascular bundle of the lower neck and upper chest. TOS can be categorized into neurogenic, venous, and arterial subtypes which result from anatomical compression of the brachial plexus, subclavian vein, and subclavian artery, respectively. This can lead to neurogenic pain as well as vascular injury with thrombosis and thromboembolism. Interventional and diagnostic radiologists play a critical role in the imaging diagnosis and treatment of vascular TOS. Prompt imaging and endovascular management with surgical collaboration has been shown to provide the most successful and long-lasting clinical outcomes, from vessel patency to symptom relief. In this article, we review the anatomy and clinical presentations of TOS as well as the initial imaging modalities used for diagnosis. Furthermore, we detail the role of the diagnostic and interventional radiologist in the management of TOS, including pre-procedure and endovascular interventions, along with medical and surgical treatments. PRECIS: Diagnostic and Interventional Radiologists play a key role in diagnosis and management of vascular thoracic outlet syndromes and are critical for timely and successful outcomes.
胸廓出口综合征（TOS）是一种由于下颈部和上胸部神经血管束受压而导致的临床疾病。TOS 可以分为神经型、静脉型和动脉型，分别是由于臂丛神经、锁骨下静脉和锁骨下动脉的解剖学压迫引起的。这可能导致神经源性疼痛以及血管损伤、血栓形成和血栓栓塞。介入和诊断放射科医生在血管 TOS 的影像学诊断和治疗中发挥着关键作用。有研究表明，及时进行影像学检查和血管内治疗，并与外科合作，可以提供最成功和持久的临床效果，从血管通畅到症状缓解。在本文中，我们回顾了 TOS 的解剖结构和临床表现以及用于诊断的初始影像学方法。此外，我们详细介绍了诊断和介入放射科医生在 TOS 管理中的作用，包括术前和血管内干预，以及药物和手术治疗。重点：诊断和介入放射科医生在血管性胸廓出口综合征的诊断和管理中发挥着关键作用，对于及时和成功的结果至关重要。
