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Research ArticleSpine

Detection of the Stellate and Thoracic Sympathetic Chain Ganglia with High-Resolution 3D-CISS MR Imaging

A. Chaudhry, A. Kamali, D.A. Herzka, K.C. Wang, J.A. Carrino and A.M. Blitz
American Journal of Neuroradiology August 2018, 39 (8) 1550-1554; DOI: https://doi.org/10.3174/ajnr.A5698
A. Chaudhry
aFrom the Departments of Neuroradiology (A.C., A.K.)
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A. Kamali
aFrom the Departments of Neuroradiology (A.C., A.K.)
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D.A. Herzka
cDepartment of Biomedical Engineering (D.A.H.), Johns Hopkins University, Baltimore, Maryland
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K.C. Wang
dDepartment of Diagnostic Radiology and Nuclear Medicine (K.C.W.), University of Maryland, School of Medicine, Baltimore, Maryland
eImaging Service (K.C.W.), Baltimore VA Medical Center, Baltimore, Maryland
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J.A. Carrino
fDepartment of Radiology and Imaging (J.A.C.), Weill Cornell Medical College, Hospital for Special Surgery, New York, New York.
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A.M. Blitz
bRadiology and Radiologic Sciences (A.M.B.), Johns Hopkins University School of Medicine, Baltimore, Maryland
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    Fig 1.

    Flow diagram of included subjects. Of the 29 subjects screened, 24 were included in this study.

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    Fig 2.

    Axial oblique reformatted 3D-CISS MR imaging at C7 demonstrates the stellate ganglion (arrow) posterior to the subclavian artery (asterisk). The technique of measurement is demonstrated on the patient's left (double-sided arrows). The stellate ganglion was found inferior and anterior to the transverse process of C7 in all patients.

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    Fig 3.

    Axial oblique CISS MR imaging through the thoracic spine illustrates the sympathetic ganglion (white arrow), rami communicantes (dashed white arrow), and the ventral ramus (black arrow) and intercostal nerve (dashed black arrow).

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    Fig 4.

    Coronal reformatted CISS through the upper thoracic region demonstrates the relationship of the second thoracic SCG (down arrow) with respect to the first and second ribs. The third SCG (up arrow) is seen just lateral to a venous flow void (arrowhead). The relationship of the SCG to adjacent venous structures is variable.

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    Fig 5.

    Sagittal oblique CISS through the paravertebral region oriented so that anterior is to the left of the image. The connection of the sympathetic chain ganglia (solid and open arrows) via the sympathetic chain (arrowhead) is visible. The rami communicantes (dashed arrow) are seen in continuity extending posteriorly toward the neural foramina.

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    Table 1:

    Summary of the mean size and SD of the thoracic SCG

    SCGMean (mm2)SD (mm2)
    Stellate ganglion36.769.27
    T213.645.60
    T310.222.64
    T49.241.50
    T58.801.07
    T68.320.83
    T78.050.75
    T87.850.80
    T97.600.84
    T107.330.86
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    Table 2:

    Size of the stellate ganglion reported by prior studies

    Author (Year of Publication)Length (mm)Width (mm)Height (mm)
    Anatomic/surgical specimen
        Moore (1954)2425105
        Kiray et al (2005)2520.68.33.9
        Zhang et al (2009)719.36.3
        Marcer et al (2012)2618.58.174.5
    MRI-based measurement
        Hogan and Erickson (1992)310 (in largest dimension)
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American Journal of Neuroradiology: 39 (8)
American Journal of Neuroradiology
Vol. 39, Issue 8
1 Aug 2018
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Cite this article
A. Chaudhry, A. Kamali, D.A. Herzka, K.C. Wang, J.A. Carrino, A.M. Blitz
Detection of the Stellate and Thoracic Sympathetic Chain Ganglia with High-Resolution 3D-CISS MR Imaging
American Journal of Neuroradiology Aug 2018, 39 (8) 1550-1554; DOI: 10.3174/ajnr.A5698

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Detection of the Stellate and Thoracic Sympathetic Chain Ganglia with High-Resolution 3D-CISS MR Imaging
A. Chaudhry, A. Kamali, D.A. Herzka, K.C. Wang, J.A. Carrino, A.M. Blitz
American Journal of Neuroradiology Aug 2018, 39 (8) 1550-1554; DOI: 10.3174/ajnr.A5698
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