3T MR tomography of the brachial plexus: Structural and microstructural evaluation

Mallouhi, Ammar; Marik, Wolfgang; Prayer, Daniela; Kainberger, Franz; Bodner, Gerd; Kasprian, Gregor

doi:10.1016/j.ejrad.2011.05.021

Cited by 64 publications

(54 citation statements)

References 19 publications

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“…The assessment of these patients is challenging and was previously largely clinical supplemented by electrodiagnostic studies and CT myelography. Now, however, CT myelography has gradually been replaced by MR neurography as in addition to being non-invasive it allows assessment of both the proximal and distal components of the brachial plexus [8]. Accurate identification of the level and extent of the injury influences patient management and prognosis.…”

Section: Discussionmentioning

confidence: 99%

MR neurography in traumatic brachial plexopathy

Upadhyaya

Kumar

et al. 2015

European Journal of Radiology

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Section: Discussionmentioning

confidence: 99%

MR neurography in traumatic brachial plexopathy

Upadhyaya

Kumar

et al. 2015

European Journal of Radiology

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Section: ©Aans 2014mentioning

confidence: 99%

“…Currently, operative exploration can confirm the extent (number of involved nerve roots) and severity of nerve injury within the brachial plexus, which is partially delineated by using preoperative modalities such as CT myelography, MRI, and electrodiagnostic studies. 1,6,10,12,14,17,18 These studies demonstrate the proximal nerve roots without showing the distal brachial plexus or terminal muscles.Ultrasonography has been reported for use in the evaluation of compressive or traumatic peripheral nerve pathology in one study 3 and for its utility in preoperative mapping in several studies. 4,7,8 However, these studies were not performed in infants, and they were not focused on the brachial plexus.…”

mentioning

confidence: 99%

Ultrasonography for neonatal brachial plexus palsy

Joseph¹,

DiPietro

Somashekar

et al. 2014

PED

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Ultrasonography has previously been reported for use in the evaluation of compressive or traumatic peripheral nerve pathology and for its utility in preoperative mapping. However, these studies were not performed in infants, and they were not focused on the brachial plexus. The authors report a case in which ultrasonography was used to improve operative management of neonatal brachial plexus palsy (NBPP). An infant boy was born at term, complicated by right-sided shoulder dystocia. Initial clinical evaluation revealed proximal arm weakness consistent with an upper trunk injury. Unlike MRI or CT myelography that focus on proximal nerve roots, ultrasonography of the brachial plexus in the supraclavicular fossa was able to demonstrate a small neuroma involving the upper trunk (C-5 and C-6) and no asymmetry in movement of the diaphragm or in the appearance of the rhomboid muscle when compared with the unaffected side. However, the supra- and infraspinatus muscles were significantly asymmetrical and atrophied on the affected side. Importantly, ultrasound examination of the shoulder revealed posterior glenohumeral laxity. Instead of pursuing the primary nerve reconstruction first, timely treatment of the shoulder subluxation prevented formation of joint dysplasia and formation of a false glenoid, which is a common sequela of this condition. Because the muscles innervated by proximal branches of the cervical nerve roots/trunks were radiographically normal, subsequent nerve transfers were performed and good functional results were achieved. The authors believe this to be the first report describing the utility of ultrasonography in the surgical treatment planning in a case of NBPP. Noninvasive imaging, in addition to thorough history and physical examination, reduces the intraoperative time required to determine the extent and severity of nerve injury by allowing improved preoperative planning of the surgical strategy. Inclusion of ultrasonography as a preoperative modality may yield improved outcomes for children with NBPP.

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“…Most clinical studies with DWN have been performed on brachial and lumbar plexus (17,41). In brachial plexus, DWN and DTN have demonstrated their ability to evaluate degenerative, compressive and traumatic conditions (42,43).…”

Section: Plexus Evaluation and Degenerative Disk Nerve Roots Entrapmementioning

confidence: 99%

“…Fractional anisotropy (FA) is the commonest used by radiologists. Other derived parameters from DTI are mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD), each one of those reflects a different property of the PN as it will be described below, and can be used as biomarkers of PN damage or regeneration (17). The evaluation of the fibers compounds of PN with DTI-neurography (DTN) is useful in the study of traumatic or tumor conditions.…”

Section: Dti Neurographymentioning

confidence: 99%

Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries

Noguerol¹,

Barousse²,

Socolovsky

et al. 2017

Quant. Imaging Med. Surg.

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Traumatic conditions of peripheral nerves and plexus have been classically evaluated by morphological imaging techniques and electrophysiological tests. New magnetic resonance imaging (MRI) studies based on 3D fat-suppressed techniques are providing high accuracy for peripheral nerve injury evaluation from a qualitative point of view. However, these techniques do not provide quantitative information. Diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) are functional MRI techniques that are able to evaluate and quantify the movement of water molecules within different biological structures. These techniques have been successfully applied in other anatomical areas, especially in the assessment of central nervous system, and now are being imported, with promising results for peripheral nerve and plexus evaluation. DWI and DTI allow performing a qualitative and quantitative peripheral nerve analysis, providing valuable pathophysiological information about functional integrity of these structures.In the field of trauma and peripheral nerve or plexus injury, several derived parameters from DWI and DTI studies such as apparent diffusion coefficient (ADC) or fractional anisotropy (FA) among others, can be used as potential biomarkers of neural damage providing information about fiber organization, axonal flow or myelin integrity. A proper knowledge of physical basis of these techniques and their limitations is important for an optimal interpretation of the imaging findings and derived data. In this paper, a comprehensive review of the potential applications of DWI and DTI neurographic studies is performed with a focus on traumatic conditions, including main nerve entrapment syndromes in both peripheral nerves and brachial or lumbar plexus.

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3T MR tomography of the brachial plexus: Structural and microstructural evaluation

Cited by 64 publications

References 19 publications

MR neurography in traumatic brachial plexopathy

MR neurography in traumatic brachial plexopathy

Ultrasonography for neonatal brachial plexus palsy

Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries

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