The Features and Diagnostic Value of MRI for Brachial Plexus Injury_West China Medical Journal

Authors：

 DENGZhen-ping ,  LIANGNa

Department of Radiology, the Second People's Hospital of Chengdu, Chengdu, Sichuan 610017, P. R. China;

Corresponding?author：

LIANGNa, Email: 21516290@qq.com

Keywords：

Brachial plexus; Injury; Magnetic resonance imaging

DOI：

10.7507/1002-0179.20140460

Video：

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Objective To explore the MRI manifestations and its diagnostic value for brachial plexus injury. Methods MRI manifestations and surgery-related materials of 21 patients confirmed to have brachial plexus injury from January 2011 to April 2013 were retrospectively analyzed. Results According to the classification of brachial plexus injury, preganglionic brachial plexus injury occurred in 13 cases (23 nerves) and postganglionic injury occurred in 8 cases (24 nerves). The manifestations of preganglionic brachial plexus injury in MRI included nerve root disappearance (11) or enlargement (9), nerve root sleeve form abnormality (3), meningeal cyst (9), catheter thickening (6), and spinal cord edema, deformation and displacement (3). Postganglionic injury MRI findings showed nerve trunk enlargement (8), continuity interrupt line (12), rigidity (4), and adjacent structure disorder and edema (6). Surgery confirmed preganglionic brachial plexus injury in 27 nerves and postganglionic injury in 29 nerves. Compared with surgery, the sensitivity, specificity and accuracy of MRI in diagnosing preganglionic brachial plexus injury were 81.5%, 80.0%, and 81.3%, respectively. The sensitivity, specificity and accuracy of MRI in diagnosing postganglionic brachial plexus injury were 79.3%, 85.7%, and 80.6%, respectively. Conclusions MRI is excellent in revealing preganglionic brachial plexus injury and postganglionic injury. MRI diagnosis accuracy is high, and it is optimal for clinical diagnosis and treatment with no invasion.

Citation： DENGZhen-ping, LIANGNa. The Features and Diagnostic Value of MRI for Brachial Plexus Injury. West China Medical Journal, 2014, 29(8): 1500-1503. doi: 10.7507/1002-0179.20140460 Copy

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3.	Viallon M, Vargas MI, Jlassi H, et al. High-resolution and functional magnetic resonance imaging of the brachial plexus using an isotropic 3D T₂ STIR (Short Term Inversion Recovery) SPACE sequence and diffusion tensor imaging[J]. Eur Radiol, 2008, 18(5):1018-1023.
4.	Takahara T, Imai Y, Yamashita T, et al. Diffusion weighted whole body imaging with background body signal suppression (DWIBS):technical improvement using free breathing, STIR and high resolution 3D display[J]. Radiat Med, 2004, 22(4):275-282.
5.	Reeder SB, Wen Z, Yu H, et al. Multicoil dixon chemical species separation with an iterative least-squares estimation method[J]. Magn Reson Med, 2004, 51(1):35-45.
6.	戴敏方, 龔霞蓉, 王波, 等. 3.0T MRI IDEAL序列顯示正常臂叢神經節后段的可行性研究[J]. 中國臨床醫學影像雜志, 2012, 23(4):291-293.
7.	Rankine JJ. Adult traumatic brachial plexus injury[J]. Clin Radiol, 2004, 59(9):767-774.
8.	張德春, 顧立強, 向劍平, 等. 高分辨率MRI診斷臂叢根性撕脫傷的臨床研究[J]. 中華顯微外科雜志, 2011, 34(5):379-381.
9.	高明勇, 梁碧玲, 許揚濱, 等. 臂叢神經根損傷的MR診斷及其應用價值[J]. 中華創傷雜志, 1999, 15(2):151-152.
10.	Hayashi N, Masumoto T, Abe O, et al. Accuracy of abnormal paraspinal muscle findings on contrast-enhanced Mr images as indirect signs of unilateral cervical root-avulsion injury[J]. Radiology, 2002, 223(2):397-402.
11.	趙秋楓, 耿道穎, 楊蓊勃. MRI在臂叢神經節前損傷診斷中的應用[J]. 中華放射學雜志, 2009, 43(1):60-64.
12.	耿明賓, 王光彬, 劉玉波, 等. 3.0T MRI在臂叢神經疾病診斷中的價值[J]. 中國中西醫結合影像學雜志, 2010, 8(6):489-492, 514.
13.	陳建宇, 劉慶余, 沈君, 等. 臂叢神經損傷的MRI診斷[J]. 中華放射學雜志, 2007, 41(6):563-568.

1. Yoshikawa T, Hayashi N, Yamamoto SA, et al. Brachial plexus injury:clinical manifestations, conventional imaging findings, and the latest imaging techniques[J]. Radiographics, 2006, 26(SI):S133-U136.
2. Filler AG, Maravilla KR, Tsuruda JS. Mr neurography and muscle Mr imaging for image diagnosis of disorders affecting the peripheral nerves and musculature[J]. Neurol Clin, 2004, 22(3):643-682.
3. Viallon M, Vargas MI, Jlassi H, et al. High-resolution and functional magnetic resonance imaging of the brachial plexus using an isotropic 3D T₂ STIR (Short Term Inversion Recovery) SPACE sequence and diffusion tensor imaging[J]. Eur Radiol, 2008, 18(5):1018-1023.
4. Takahara T, Imai Y, Yamashita T, et al. Diffusion weighted whole body imaging with background body signal suppression (DWIBS):technical improvement using free breathing, STIR and high resolution 3D display[J]. Radiat Med, 2004, 22(4):275-282.
5. Reeder SB, Wen Z, Yu H, et al. Multicoil dixon chemical species separation with an iterative least-squares estimation method[J]. Magn Reson Med, 2004, 51(1):35-45.
6. 戴敏方, 龔霞蓉, 王波, 等. 3.0T MRI IDEAL序列顯示正常臂叢神經節后段的可行性研究[J]. 中國臨床醫學影像雜志, 2012, 23(4):291-293.
7. Rankine JJ. Adult traumatic brachial plexus injury[J]. Clin Radiol, 2004, 59(9):767-774.
8. 張德春, 顧立強, 向劍平, 等. 高分辨率MRI診斷臂叢根性撕脫傷的臨床研究[J]. 中華顯微外科雜志, 2011, 34(5):379-381.
9. 高明勇, 梁碧玲, 許揚濱, 等. 臂叢神經根損傷的MR診斷及其應用價值[J]. 中華創傷雜志, 1999, 15(2):151-152.
10. Hayashi N, Masumoto T, Abe O, et al. Accuracy of abnormal paraspinal muscle findings on contrast-enhanced Mr images as indirect signs of unilateral cervical root-avulsion injury[J]. Radiology, 2002, 223(2):397-402.
11. 趙秋楓, 耿道穎, 楊蓊勃. MRI在臂叢神經節前損傷診斷中的應用[J]. 中華放射學雜志, 2009, 43(1):60-64.
12. 耿明賓, 王光彬, 劉玉波, 等. 3.0T MRI在臂叢神經疾病診斷中的價值[J]. 中國中西醫結合影像學雜志, 2010, 8(6):489-492, 514.
13. 陳建宇, 劉慶余, 沈君, 等. 臂叢神經損傷的MRI診斷[J]. 中華放射學雜志, 2007, 41(6):563-568.

West China Medical Journal

The Features and Diagnostic Value of MRI for Brachial Plexus Injury

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