MRI Diagnosis of the Brachial Plexus Lesions

Abstract

Summary. Damage to the brachial plexus (brachial plexopathy) is considered one of the most severe pathologies of the upper limb, which can lead to gross impairment of function and permanent disability of the patient. Today, MRI diagnostics is the first-line method for visualizing normal anatomy and pathological conditions of the brachial plexus (BP).
 Objective: to optimize the diagnosis of BP pathology based on the study of diagnostic capabilities of magnetic resonance imaging (MRI).
 Materials and Methods. A retrospective analysis of MRI data of 62 patients with traumatic injury of the BP (group 1) and 23 patients with lesions of non-traumatic genesis (group 2) was performed. The MRI examination was performed on a PHILIPS Achieva magnetic resonance tomograph with a magnetic field strength of 1.5 T using sequences of T1 and T2 weighted images (33), a 3DT2 DRIVE sequence with a high degree of resolution, and STIR sequences in axial, sagittal and coronal projections.
 Results. The MRI picture of brachial plexopathies was quite diverse and depended on the etiology of the lesion, the level and severity of damage to neural structures. When analyzing the MRI studies of patients of group 1, preganglionic lesion was detected in 39 patients (62.9%); 8 patients (12.9%) had trunks lesion and 15 patients (24.2%) had cords lesion. In group 2, BP ​​dysfunction associated with detected MRI signs of a tumor of nerve structures or infiltration and/or compression of the brachial plexus by a tumor of other organs or a metastasis was detected in 21 patients (84%); BP ​​dysfunction resulted from radiation therapy in 2 patients (8.7%) and from the disease – neuralgic amytrophy – in 2 patients (8.7%). The use of MRI made it possible to carry out a differential diagnosis of pathology and to determine the nature, extent and degree of severity of damage to nervous structures.
 Conclusions. MRI examination is an effective method of diagnosing the brachial plexus pathology, which makes it possible to determine the level, extent and severity of the damage, and to justify the further treatment of this category of patients at the early stages.