NeuroTalk Support Groups - MRI

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- Thoracic Outlet Syndrome (https://www.neurotalk.org/thoracic-outlet-syndrome/)

- - MRI - necessary? (https://www.neurotalk.org/thoracic-outlet-syndrome/173179-mri.html)

MRI - necessary?

one doc wants to do an MRI to rule out neck issues but also it includes MRI of thoracic outlet. will this even show anything?

If you've never had any imaging , it really is best for ruling in/out of any other causes. Often TOS gets diagnosed by excluding all other causes & reasons for the symptoms.

You may have some anomalie that will show up and will give a better idea on future treatment or is surgery is needed.

If ins will cover it/ you can afford it, I think yes.
Or x rays first might give a hint if MRI would be needed.

Quote:

Originally Posted by heybro (Post 897176)

one doc wants to do an MRI to rule out neck issues but also it includes MRI of thoracic outlet. will this even show anything?

I've had both. My mri showed disc issues but that doesnt rule out TOS.and my brachial plexus MRI showed neural edema which points to TOS but you cant see where the compression is. Try to find the highest resolution machine available . i think mine was only 1.5 Tesla and I think there is 3 Tesla around. Marc posted abut this before. Both were helpful.

Quote:

Originally Posted by heybro (Post 897176)

one doc wants to do an MRI to rule out neck issues but also it includes MRI of thoracic outlet. will this even show anything?

MRI of the thoracic outlet can show neural edema as well as signs of scarring but may not show anything relating to TOS (I think a lot depends on the radiologist reading the imaging). Try and find an imaging center with 3 Tesla MRI if you can...1.5 T at a minimum (open MRI is usually 0.75T but they have 1.5 T machines now). There is such thing as a 7 Tesla but it is still experimental and insurance won't pay for it.

MRI with contrast (MRA - Angiogram) is useful in showing vascular TOS signs. Hopefully your doctor has ordered this and included the hands-up position. Here is a post of mine right before I had surgery:

Quote:

Originally Posted by nospam (Post 866074)

I received the results of my MRI/MRA/MRV today. The test didn't show any evidence of brachial plexus or arterial compression, but does show narrowing of the subclavian veins in the hands-up position (left greater than right, complete blockage on the left). Not surprising except for maybe the venous compression which I had not suspected.

I feel like the MRI is very limited in the fact that the hands-up position achieved in the MRI machine is not one which reproduces my arterial or neurogenic symptoms. The EAST, "Stick-em-up" test (http://www.nismat.org/ptcor/thoracic_outlet) most quickly exacerbates my symptoms. With this test, the symptoms actually are worse on the right than the left even though the left is generally worse in daily life. I am more convinced now that Dr. Ahn's angiogram is a more effective test than the MRI/MRA/MRV since he can maneuver the arms into more provocative positions than can be done in the MRI. I still believe that his testing would simply confirm the clinical exams (which is why I'm not rushing back to Ahn for the test). Perhaps as higher resolution open-MRI becomes more available the MRI testing can be further expanded (as MRI is less invasive than the balloon angioplasty Ahn uses).

Quote:

Originally Posted by nospam (Post 897319)

wait wait wait, you had to put your arms up above your head for this test?

i have had an MRI before and I had to stay very still for a long period of time. THERE IS NO WAY IN HEAL THAT I COULD HAVE MY ARMS OVER MY HEAD either laying or standing for more than, say 15 seconds before having loss of blood and shaking start.

Quote:

Originally Posted by heybro (Post 897358)

Yes, my arms were above my head for about 15 minutes. It was not fun.

Others have had an adverse reaction or launched in a flare that lasted indefinitely...so don't do this if this is the case with you.

Quote:

Originally Posted by heybro (Post 897358)

Is that just for the MRA ? For my bp mri, my arms were down at my side, but I had to be lightly sedated,because I get claustrophobic (it takes about 50 minutes) . It went really fast-I highly recommend the sedation.

ditto heybro, I could not do that either for more than a few seconds.

Quote:

Originally Posted by jkl626 (Post 897429)

Yea the one they are talking about is different than the bp MRI, I also had my arms down and it was about 40 minutes.

Heybro I think you should try to get a regular MRI of your neck first if you haven't done so and/or your bp.

Quote:

Originally Posted by jkl626 (Post 897429)

Is that just for the MRA ?

Yep, just for the angiogram portion of the test. I think the contrast without the arms up might still show clotting or narrowing if it were a severe case of TOS.