To demonstrate the use of ultrasound in posttraumatic brachial plexus imaging To review the sonographic appearance of traumatic brachial plexus injury
Brachial plexus trauma is often associated with high velocity events such as motorcycle or automobile accidents,
or in penetrating injury such as gunshot or stab wounds. For preganglionic brachial plexus injury,
CT myelography is the gold standard for imaging.
Postganglionic injury is well assessed using MR neurography,
as it can characterize nerve pathology and detect muscle denervation. In some cases,
MRI cannot be performed due to limited availability or patient contraindication.
Imaging findings OR Procedure Details
ULTRASOUND IMAGING TECHNIQUE For successful imaging of the post-ganglionic brachial plexus,
high-resolution transducers are recommended.
At our institution,
12-18 MHz transducers are routinely employed.
Both still and cine imaging of the brachial plexus are useful. NORMAL SONOGRAPHIC APPEARANCE OF THE BRACHIAL PLEXUS The postganglionic brachial plexus is evaluated in four main locations in the neck and chest: paravertebral,
supraclavicular and infraclavicular (Figure 1).
Sonography is useful in the imaging of postganglionic brachial plexus trauma,
with ability to detect root avulsion,
transection injury and scar encasement.
Brachial plexus sonography: a technique for assessing the root level.
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