Learning objectives
The aim of the review is to:
Describenormal brachial plexus anatomy.
Discuss theMRI sequences employed to ensure optimalimaging of the brachial plexus.
Showcase various brachial plexus pathologies that may be encountered in daily practice.
Background
The brachial plexus provides motor and sensory innervation to the upper extremity.
MRI is the gold standardfor the assessment ofthe brachial plexus owing to its superior soft tissue resolution in depicting brachial plexus anatomy,
as well as its multiplanar capabilities.
Brachial plexopathies can be broadly divided into:
(1) traumatic causes
(2) non-traumatic causes,
which can befurther divided into:
infective
inflammatory neuritis/neuropathy
benign or malignant neoplasm
radiation-induced plexopathy
vascular abnormalities
extrinsic compression.
Imaging findings OR Procedure Details
Our centre uses thePhilips Ingenia 1.5 Tesla MRI scannerto image thebrachial plexus.
Bilateralbrachial plexuses are imaged to allow comparison and better detection of abnormalities.
MRIprotocol:
Coronal 3D STIR (include both shoulders)FOV – 350mm TR,TE – 3000ms,
194ms,
ST/GAP – 1.4 mm,
0.7mm Matrix – 252/249
Coronal MIPFOV- 350mm TR,TE- 3000ms,
194ms,
ST/GAP -2mm,
2mm Matrix 252/249
Coronal T1 (include both shoulders)FOV – 320mm,
TR,TE – 647ms,
6ms,
ST/GAP – 3mm,
0.3mm Matrix – 415/341
Axial STIR (C5 to inferior axilla,
single-side)FOV – 200mm TR,TE –...
Conclusion
The brachial plexus is a complex network of nerves which is responsible for the sensory and motor innervation of the upper limb.
Pathologies involving the brachial plexus can result insignificant physical dysfunction.
MRI is the imaging modality of choice to demonstrate anatomy and pathology of the brachial plexus,
and weshowcasea variety of MRI cases to illustrate the various ways the brachial plexus may be affected by disease.
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