MR imaging of the brachial plexus: Current imaging sequences, normal findings, and findings in a spectrum of focal lesions with MR-pathologic correlation

Kichari, Jayant R.; Hussain, Shahid; Hollander, Jan C. den; Krestin, Gabriël P.

doi:10.1016/s0363-0188(03)90005-3

Cited by 15 publications

(10 citation statements)

References 17 publications

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“…MRI is the modality of choice for the diagnosis of spinal cord diseases in humans and is becoming more widely available in veterinary medicine. The major advantages of MRI compared with other imaging modalities is obtaining images in multiple planes and the superior resolution for imaging soft tissues, such as the spinal cord, nerve roots, skeletal muscle, brachial plexus region, or intervertebral discs …”

Section: Discussionmentioning

confidence: 99%

Chronic Hypertrophic Ganglioneuritis Mimicking Spinal Nerve Neoplasia: Clinical, Imaging, Pathologic Findings, and Outcome after Surgical Treatment

Ródenas

Summers

Saveraid³

et al. 2012

Veterinary Surgery

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Section: Discussionmentioning

confidence: 99%

Chronic Hypertrophic Ganglioneuritis Mimicking Spinal Nerve Neoplasia: Clinical, Imaging, Pathologic Findings, and Outcome after Surgical Treatment

Ródenas

Summers

Saveraid³

et al. 2012

Veterinary Surgery

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“…MRI is currently the preferred modality for brachial plexus assessment . Routine examination protocols typically consist of 2D acquisitions in multiple anatomical planes, 3D imaging, or some combination of both . Recently, Tagliafico et al showed that 2D and 3D sequences generate similar image quality and nerve conspicuity for plexus MRI .…”

Section: Discussionmentioning

confidence: 99%

“…Vargas et al prescribed quiet breathing during data collection to minimize lung motion . Alternatively, Kichari et al employed a combination of breath holding and RT . However, quiet breathing and/or breath holding are not always clinically feasible and are unreliable for motion suppression, as they require adequate patient compliance.…”

Section: Discussionmentioning

confidence: 99%

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Prospective respiratory triggering improves high‐resolution brachial plexus MRI quality

Sneag

Mendapara

Zhu

et al. 2018

Magnetic Resonance Imaging

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Background Oblique sagittal MRI sequences, orthogonal to the longitudinal axis of the brachial plexus, can reliably depict morphologic and signal abnormalities. However, nerve visualization may be obscured by ghosting artifact from periodic respiratory motion. Respiratory triggering (RT) with a thoracoabdominal bellows can reduce ghosting artifact, but it is not routinely used for brachial plexus MRI. Furthermore, the efficacy of prospective RT for brachial plexus imaging has not yet been reported. Purpose To compare brachial plexus MRI sequences acquired with and without respiratory triggering. Study Type Prospective. Subjects Five volunteers and 20 patients were included. Each subject was imaged with and without RT during the same session. Field Strength/Sequence Proton density or T2‐weighted Dixon fat suppressed sequences were obtained at 3.0T using receive‐only 16‐channel flexible array coils. Assessment Three musculoskeletal radiologists blindly evaluated each sequence using subjective scoring criteria for ghosting artifact, nerve conspicuity, and diagnostic confidence. Nerve conspicuity scores at three distinct plexus levels were summed to calculate an overall image quality score. Statistical Tests Marginal proportional odds logistic regression models were used to compare all scores between RT and non‐RT. Gwet's agreement coefficient was used to assess interobserver and intraobserver reliability. Results Mean scan time per sequence increased from 4:25 minutes (95% confidence interval [CI], 4:02–4:49 min) with non‐RT to 6:09 minutes (95% CI, 5:42–6:35 min) with RT. RT reduced ghosting artifact (odds ratio [OR] = 0.21, 95% CI: 0.09–0.46, P < 0.001), improved overall image quality (OR = 4.88, 95% CI: 2.18–10.95, P < 0.001), and increased diagnostic confidence (OR = 3.72, 95% CI: 1.61–8.63, P = 0.002) for all readers. Interobserver agreement for ghosting artifact and image quality was substantial to almost perfect (AC2 = 0.74–0.85). Interobserver agreement for all other scores was moderate to almost perfect (AC2 = 0.61–0.82). Intraobserver agreement was substantial to almost perfect for all parameters (AC2 = 0.76–1.0). Data Conclusion Prospective RT with bellows can effectively minimize ghosting artifact and improve image quality for brachial plexus MRI within clinically optimal acquisition times. Level of Evidence: 1 Technical Efficacy: Stage 2

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“…Metastatic lesions typically appear with low signal on T1-weighted sequences and increased on T2-weighted sequences. Lesions originating in the lung parenchyma usually have an irregular interface with the pulmonary parenchyma, whereas pleural and extrapleural lesions tend to have smooth borders 5 7…”

Section: Discussionmentioning

confidence: 99%

Pancoast’s syndrome caused by lymph node metastasis from breast cancer

et al. 2018

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Pancoast’s syndrome may be the result of neoplastic, inflammatory or infectious disease. We report an unusual case of Pancoast’s syndrome in a patient with metastatic breast cancer. A 54-year-old woman, affected by metastatic breast cancer, presented for severe shoulder pain, paraesthesia and numbness in the right arm. Despite further multiple lines of systemic chemotherapy, she developed a progressive enlargement of retropectoral, supraclavicular and infraclavicular lymph node metastases, which involved brachial plexus, apex of lung and anterior mediastinum. Physical examination revealed severe weakness of proximal muscles of the right arm. Neuropathic pain was managed with pharmacological treatment. Lastly, the patient has been treated with intrathecal analgesia with morphine and ziconotide with a good control of pain. The patient died after 3 months.

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MR imaging of the brachial plexus: Current imaging sequences, normal findings, and findings in a spectrum of focal lesions with MR-pathologic correlation

Cited by 15 publications

References 17 publications

Chronic Hypertrophic Ganglioneuritis Mimicking Spinal Nerve Neoplasia: Clinical, Imaging, Pathologic Findings, and Outcome after Surgical Treatment

Chronic Hypertrophic Ganglioneuritis Mimicking Spinal Nerve Neoplasia: Clinical, Imaging, Pathologic Findings, and Outcome after Surgical Treatment

Prospective respiratory triggering improves high‐resolution brachial plexus MRI quality

Pancoast’s syndrome caused by lymph node metastasis from breast cancer

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