Abstract
ABSTRACTObjective:To compare magnetic resonance imaging and intraoperative findings in patients diagnosed with traumatic injury to the brachial plexus. Methods:Patients with a diagnosis of traumatic injury to the brachial plexus admitted to the hand and microsurgery outpatient consult of the Hospital das Clínicas at the University of São Paulo were selected during December 2016. A total of three adult patients with up to six months of injury who underwent surgical treatment were included in the study. A diffusion-weighted sequence magnetic resonance protocol and fluid-sensitive volumetric reformatting sequence were applied. The magnetic resonance results were compared with the diagnoses obtained from the injuries observed during the surgery. The study was double-blind (surgeon and radiologist). Results:A descriptive correlation was found between the magnetic resonance imaging results and the diagnostic findings from the surgeries, for both pre- and post-ganglionic injuries. Conclusion:Magnetic resonance imaging has shown to be a promising diagnostic method in preoperative assessment of brachial plexus lesions; it is less invasive than other common methods, showing not only avulsion lesions but also localized postganglionic lesions in the supra- and infraclavicular region. Level of Evidence III; Diagnostic studies - Investigating a diagnostic test.
Highlights
Brachial plexus injury is considered the most serious neural alteration of the limbs, and is a significant challenge for those who treat it.[1]
Magnetic resonance imaging has shown to be a promising diagnostic method in preoperative assessment of brachial plexus lesions; it is less invasive than other common methods, showing avulsion lesions and localized postganglionic lesions in the supraand infraclavicular region
A close descriptive correlation was seen between the magnetic resonance imaging (MRI) reports using the technique in question and the diagnostic findings from the surgeries of the three patients
Summary
Brachial plexus injury is considered the most serious neural alteration of the limbs, and is a significant challenge for those who treat it.[1] Traumatic injuries in adults are mostly caused by traction on the neck and shoulder in high-energy accidents.[2] The exponential increase in cases of brachial plexus injury in Brazil, especially in large cities, is associated with car and motorcycle accidents, which correspond to 80-90% of cases.[2,3]. Several classifications have been proposed for traumatic injuries to the brachial plexus. For decision-making and prognosis, they are commonly classified into three categories according to anatomical parameters: pre-ganglionic (root avulsion), post-ganglionic (rupture or injury in the continuity of the nerve), or a combination of both.[4,5] In this context, electrodiagnostic and imaging tests have become important tools in anatomical location of these injuries. All authors declare no potential conflict of interest related to this article
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