Role of MRI in the diagnosis of adult traumatic and obstetric brachial plexus injury compared to intraoperative findings

Doria Mohammed Gad,Hazem Abu Zeid Yousef,Mohamed Abdel-Tawab,Mohamed Mostafa Kotb,Mostafa Thabet Hussein,Nagham Nabil Mahmoud Omar

doi:10.1186/s43055-020-00310-2

Doria Mohammed Gad, Hazem Abu Zeid Yousef + Show 4 more

Open Access

https://doi.org/10.1186/s43055-020-00310-2

Copy DOI

Abstract

BackgroundBrachial plexus injury occurs following birth trauma or adult trauma as well, surgical repair is important to regain upper limb function, and preoperative evaluation with MRI is important and considered the accurate and safe imaging modality.Thirty-seven patients with clinically suspected obstetric (15 patients) or adult traumatic (22 patients) brachial plexus injury were included in our study; all of them underwent MRI examination including T1WI, T2WI, STIR, DWIBS, 3D STIR SPACE, and MR myelography sequences.ResultsIn obstetric cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 63%, 89%, and 82%, respectively, while for postganglionic lesions, MRI sensitivity, specificity, and accuracy were 60%, 99%, and 95%, respectively. In adult cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 96%, 95%, and 95% respectively, while for postganglionic injury, MRI sensitivity, specificity, and accuracy were 60%, 100%, and 99%, respectively.ConclusionMRI represents a safe, non-invasive, diagnostic modality having the multiplanar capability and better soft tissue characterization.

Highlights

Brachial plexus injury occurs following birth trauma or adult trauma as well, surgical repair is important to regain upper limb function, and preoperative evaluation with Magnetic resonance imaging (MRI) is important and considered the accurate and safe imaging modality
MRI examination of brachial plexus was done for 37 patients with clinically suspected traumatic or obstetric brachial plexopathy
Twentytwo patients were presented with traumatic brachial plexus injury: 20 males and 2 females, mean age 26.3 years (7–51 years)

Summary

Introduction

Brachial plexus injury occurs following birth trauma or adult trauma as well, surgical repair is important to regain upper limb function, and preoperative evaluation with MRI is important and considered the accurate and safe imaging modality. Thirty-seven patients with clinically suspected obstetric (15 patients) or adult traumatic (22 patients) brachial plexus injury were included in our study; all of them underwent MRI examination including T1WI, T2WI, STIR, DWIBS, 3D STIR SPACE, and MR myelography sequences. Traumatic brachial plexus injuries affect 1% of patients involved in major trauma [7]. Brachial plexopathy may cause everlasting disability [8,9,10,11,12], pain [12,13,14], Clinical examination is not accurate in brachial plexus injuries owing to the complicated plexus design and the complex nature of the lesions. The delay from injury to surgical repair is the leading cause of poor outcome [20,21,22]

Methods

Results

Discussion

Conclusion