Type:
Educational Exhibit
Keywords:
Inflammation, Hernia, Education and training, Technical aspects, Imaging sequences, Computer Applications-3D, Neural networks, MR-Diffusion/Perfusion, MR, Radiographers, Neuroradiology peripheral nerve, Anatomy
Authors:
A. P. Dominguez Castilla1, D. Sancho2, A. Merina2, C. Garcia Ansola2, J. BACHILLER EGEA2, L. LOPEZ RUIZ3; 1Villaviciosa de odon, M/ES, 2MADRID/ES, 3MADRID, casado/ES
DOI:
10.26044/ecr2019/C-0943
Background
Anatomy review of the brachial plexus.
The brachial plexus is a group of nerves that come form the spinal cord in the neck and travel down the arm.
These nervers control the muscles of the shoulder,
elbow,
wrist,
and hand,
as well as provide feeling in the arm.
Some brachial plexus injuries are minor and will completely recover in several weeks.
Other injuries are severe enough and could cause some permanent disability in the arm.
The brachial plexus is divided into five roots three trunks,
six divisions ( three anterior and three posterior),
three cords and five branches.
There are five terminal branches and numerous other pre-terminal or collateral branches,
sch as the subscapular nerve,
the thoracodorsal nerve,
and the long thoracic nerve,
that leave the plexus at variuous points along its lengh.
A common structure used to identify part of the brachial plexus in cadaver dissections is the M or W shape made by the musculocutaneos nerve,
lateral cord. median nerve,
medial cord,
and ulnar nerve.( Figure 1.)
Fig. 2
MRI assessment of the brachial plexus has commonly been a challenge for radiologist and techniciens.
The combination of the complex anatomy,
with the inhomogeneous fat suppression and the low signal intensity of the supraclavicular area,
in the addition of flow and motion artifacts with breathing,
complicate the acquisition of this type of MR study.
Examples:
Figure 3 artefact of movement and low signal in the cords.
Figure 4 artefact of subclavian vein signal.
Fig. 5: Motion artifact and low signal in the cords.
Fig. 6