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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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, 龚霞蓉, 王波, 等. 3.0T MRI IDEAL序列显示正常臂丛神经节后段的可行性研究[J]. 中国临床医学影像杂志, 2012, 23(4):291-293.
7.	Rankine JJ. Adult traumatic brachial plexus injury[J]. Clin Radiol, 2004, 59(9):767-774.
8.	张德春, 顾立强, 向剑平, 等. 高分辨率MRI诊断臂丛根性撕脱伤的临床研究[J]. 中华显微外科杂志, 2011, 34(5):379-381.
9.	高明勇, 梁碧玲, 许扬滨, 等. 臂丛神经根损伤的MR诊断及其应用价值[J]. 中华创伤杂志, 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.	赵秋枫, 耿道颖, 杨蓊勃. MRI在臂丛神经节前损伤诊断中的应用[J]. 中华放射学杂志, 2009, 43(1):60-64.
12.	耿明宾, 王光彬, 刘玉波, 等. 3.0T MRI在臂丛神经疾病诊断中的价值[J]. 中国中西医结合影像学杂志, 2010, 8(6):489-492, 514.
13.	陈建宇, 刘庆余, 沈君, 等. 臂丛神经损伤的MRI诊断[J]. 中华放射学杂志, 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, 龚霞蓉, 王波, 等. 3.0T MRI IDEAL序列显示正常臂丛神经节后段的可行性研究[J]. 中国临床医学影像杂志, 2012, 23(4):291-293.
7. Rankine JJ. Adult traumatic brachial plexus injury[J]. Clin Radiol, 2004, 59(9):767-774.
8. 张德春, 顾立强, 向剑平, 等. 高分辨率MRI诊断臂丛根性撕脱伤的临床研究[J]. 中华显微外科杂志, 2011, 34(5):379-381.
9. 高明勇, 梁碧玲, 许扬滨, 等. 臂丛神经根损伤的MR诊断及其应用价值[J]. 中华创伤杂志, 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. 赵秋枫, 耿道颖, 杨蓊勃. MRI在臂丛神经节前损伤诊断中的应用[J]. 中华放射学杂志, 2009, 43(1):60-64.
12. 耿明宾, 王光彬, 刘玉波, 等. 3.0T MRI在臂丛神经疾病诊断中的价值[J]. 中国中西医结合影像学杂志, 2010, 8(6):489-492, 514.
13. 陈建宇, 刘庆余, 沈君, 等. 臂丛神经损伤的MRI诊断[J]. 中华放射学杂志, 2007, 41(6):563-568.

West China Medical Journal

The Features and Diagnostic Value of MRI for Brachial Plexus Injury

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