Ultrasonography of the brachial plexus, normal appearance and practical applications

Abstract

Ultrasound examination of the brachial plexus, although at first sight difficult, is perfectly feasible with fairly rapid practical and theoretical training. The roots are accurately identified due to the shape (a single tubercle) of the transverse process of C7 in the paravertebral space, and the superficial position of C5 in the interscalene groove. The téléphérique technique allows the roots, trunks and cords to be followed easily into the supraclavicular fossa. In just a few years, ultrasound imaging of the plexus has become a routine anesthesia examination for guiding nerve blocks. In trained hands, it also provides information in thoracic outlet syndromes, traumatic conditions (particularly for postganglionic lesions) and tumoral diseases. Even if MRI remains the standard examination in these indications, ultrasound, with its higher definition and dynamic character, is an excellent additional method which is still under-exploited.

Thoracic outlet syndrome: clinical and diagnostic features

“…Приобретенные причины объединяют так называе-мые функциональные, посттравматические факторы и вторичное поражение сосудистого нервного пучка вследствие таких состояний, как опухоль верхушки легкого или лимфаденомегалия [18,22]. По данным ряда авторов, посттравматические причины составля-ют до 2 / 3 случаев TOS [23,24].…”

“…Сегодня активно обсужда-ется диагностическая значимость метода в исследова-нии нервных стволов, в том числе при нейрогенном TOS [22,46,47,51,52]. УЗИ плечевого сплетения с провокационными маневрами, которое показало свою эффективность в подтверждении нейрогенного TOS, подробно описано в работе S. M. Fried и соавт.…”

Current Approach to Obstetric Brachial Plexus Palsy

“…In experienced hands, sufficient information is provided for thoracic outlet syndrome, traumatic events and tumoral diseases. In these cases although MR is still the standard imaging method, with highresolution and dynamic character for which experience has not yet been gained, US is an excellent additional diagnostic method [7]. In a study in which the severity of BPP in newborns was quantitatively evaluated with US, the ultrasonographic properties of the muscles after damage were examined.…”

Neurogenic thoracic outlet syndrome: current diagnostic criteria and advances in MRI diagnostics

“…24 In addition to contributing to the initial diagnosis, im- While our study has focused primarily on the role of MRI, ultrasonography may also serve as an excellent diagnostic tool for nTOS when performed by a skilled practitioner, particularly for evaluating neural compression during dynamic movements, such as with the Adson or Wright test. 12,17 Ultrasound may be an especially useful adjunct for patients with disputed TOS where compression is equivocal on MR neurograms or electrodiagnostic studies.…”