Abstract
BackgroundCervical plexus (CP) tumours are difficult to diagnose because of atypical symptoms. This study aimed to summarize the features of a normal CP and CP tumours observed on high-frequency ultrasonography.MethodsThe ultrasound data of 11 CP tumour patients and 22 normal volunteers were collected. All 11 patients underwent magnetic resonance imaging (MRI), and 4 patients also underwent computed tomography (CT). The imaging data were compared with surgery and pathology data.ResultsThe C7 vertebra and bifurcation of the carotid common artery (CCA) were useful anatomic markers for identifying the CP. In contrast to the C1 nerve (22.7%), the C2-4 nerves were well displayed and thinner than the brachial plexus (P < 0.05). CP tumours were more common in females (72.7%) and generally located at C4 (72.7%) on the right side (81.8%). Additionally, the nerve trunk in tumour patients was obviously wider than that in normal controls (7.49 ± 1.03 mm vs 2.67 ± 0.36 mm, P < 0.01). Compared with pathology, the diagnostic rates of CP tumours by MRI, CT and high-frequency ultrasound were 72.7% (8/11), 25% (1/4) and 90.9% (10/11), respectively.ConclusionsThe diagnosis of CP neuropathy is accurate and reliable by high-frequency ultrasound, and the C7 vertebra and bifurcation of the CCA are useful anatomic markers in CP ultrasonography.
Highlights
Cervical plexus (CP) tumours are difficult to diagnose because of atypical symptoms
We found that two land markers were useful in identifying the CP. (1) The C7 vertebra: C7 is unique because it has a posterior tubercle only and can be found (Fig. 1C); C4-1 can be confirmed from bottom to top
(2) Bifurcation of the common carotid artery (CCA): The bifurcation of the carotid common artery (CCA) is at the C4 level, which can be used as a land marker for C4 recognition (Fig. 1D)
Summary
Cervical plexus (CP) tumours are difficult to diagnose because of atypical symptoms. This study aimed to summarize the features of a normal CP and CP tumours observed on high-frequency ultrasonography. Because of the higher location and atypical symptoms, most patients with CP tumor went to clinic for neck mass, some with concomitant pain, and CP masses are quite similar to lymph node or thyroid nodules upon palpation, so the presurgical diagnosis of these tumours is challenging [3]. High-frequency ultrasonography provides superior imaging, with resolution up to 30 μm, which is sufficient for establishing the precise type and level of nerve injury [5].
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