Role of MRI in Evaluation and Characterization of Brachial Plexopathies
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 5
Abstract
Brachial plexopathies are difficult to accurately diagnose, even with a meticulous investigation because the anatomic design of the plexus pose challenges, and also because the types of lesions and injuries that occur are frequently complex. Thus establishing a precise anatomic diagnosis and estimating the severity of the lesion is imperative for prognostic, surgical, and rehabilitative purposes. Evaluation of the brachial plexus is a clinical challenge and clinical examination and EMG (electrophysiological studies) provide only functional details without providing information regarding lesion localization and characterisation. MRI is currently the imaging modality of choice for evaluation of brachial plexus pathologies. MRI is valuable in identifying, localizing and characterizing the lesions affecting the brachial plexus and in differentiating the various traumatic lesions into pre-ganglionic and post-ganglionic which is critical for decision making and surgical planning, whether to proceed with exploration, nerve repair or nerve transfer. In this study a total of 50 patients were taken out of these 28(56%) were traumatic and rest were non traumatic 22 (44%). Amongst the traumatic lesions, post-ganglionic injuries(78.5%) were more common than pre-ganglionic(60.5%). Over all stretch injury(64%) was the most common cause of traumatic brachial plexopathies. In our study MRI had an accuracy of 97.5% in cases of root avulsion with 100% accuracy in other traumatic lesions(pseudomeningocele and transected nerve) whereas it was found to be 100% in nontraumatic brachial plexopathies such as primary and secondary tumors. Keywords: Brachial plexus MRI, brachial plexopathies, preganglionic/postganglionic nerve injuries.
Authors and Affiliations
Dr. Alka Agarwal, Dr. Abhinav Sahu, Dr. Awesh Gambre, Dr. P. S. Tripathi, Dr. Preety Kochar, Dr. Rituja Prakash
Keywords
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