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Magnetic resonance imaging of the brachial plexus. Part 1 : Anatomical considerations, magnetic resonance techniques, and non-traumatic lesions

Szaro, Pawel ; McGrath, Alexandra ; Ciszek, Bogdan and Geijer, Mats LU (2022) In European Journal of Radiology Open 9.
Abstract

For magnetic resonance imaging (MRI) of non-traumatic brachial plexus (BP) lesions, sequences with contrast injection should be considered in the differentiation between tumors, infection, postoperative conditions, and post-radiation changes. The most common non-traumatic inflammatory BP neuropathy is radiation neuropathy. T2-weighted images may help to distinguish neoplastic infiltration showing a high signal from radiation-induced neuropathy with fibrosis presenting a low signal. MRI findings in inflammatory BP neuropathy are usually absent or discrete. Diffuse edema of the BP localized mainly in the supraclavicular part of BP, with side-to-side differences, and shoulder muscle denervation may be found on MRI. BP infection is caused... (More)

For magnetic resonance imaging (MRI) of non-traumatic brachial plexus (BP) lesions, sequences with contrast injection should be considered in the differentiation between tumors, infection, postoperative conditions, and post-radiation changes. The most common non-traumatic inflammatory BP neuropathy is radiation neuropathy. T2-weighted images may help to distinguish neoplastic infiltration showing a high signal from radiation-induced neuropathy with fibrosis presenting a low signal. MRI findings in inflammatory BP neuropathy are usually absent or discrete. Diffuse edema of the BP localized mainly in the supraclavicular part of BP, with side-to-side differences, and shoulder muscle denervation may be found on MRI. BP infection is caused by direct infiltration from septic arthritis of the shoulder joint, spondylodiscitis, or lung empyema. MRI may help to narrow down the list of differential diagnoses of tumors. The most common tumor of BP is metastasis. The most common primary tumor of BP is neurofibroma, which is visible as fusiform thickening of a nerve. In its solitary state, it may be challenging to differentiate from a schwannoma. The most common MRI finding is a neurogenic variant of thoracic outlet syndrome with an asymmetry of signal and thickness of the BP with edema. In abduction, a loss of fat directly related to the BP may be seen. Diffusion tensor imaging is a promising novel MRI sequences; however, the small diameter of the nerves contributing to the BP and susceptibility to artifacts may be challenging in obtaining sufficiently high-quality images.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Brachial plexus, Compression, Injury, Neuropathy, Tumor
in
European Journal of Radiology Open
volume
9
article number
100392
publisher
Elsevier
external identifiers
  • pmid:34988263
  • scopus:85121557109
ISSN
2352-0477
DOI
10.1016/j.ejro.2021.100392
language
English
LU publication?
yes
id
e31dc531-9c9e-4ef6-b177-c134f6df5b75
date added to LUP
2022-03-15 15:40:16
date last changed
2024-06-22 06:38:08
@article{e31dc531-9c9e-4ef6-b177-c134f6df5b75,
  abstract     = {{<p>For magnetic resonance imaging (MRI) of non-traumatic brachial plexus (BP) lesions, sequences with contrast injection should be considered in the differentiation between tumors, infection, postoperative conditions, and post-radiation changes. The most common non-traumatic inflammatory BP neuropathy is radiation neuropathy. T2-weighted images may help to distinguish neoplastic infiltration showing a high signal from radiation-induced neuropathy with fibrosis presenting a low signal. MRI findings in inflammatory BP neuropathy are usually absent or discrete. Diffuse edema of the BP localized mainly in the supraclavicular part of BP, with side-to-side differences, and shoulder muscle denervation may be found on MRI. BP infection is caused by direct infiltration from septic arthritis of the shoulder joint, spondylodiscitis, or lung empyema. MRI may help to narrow down the list of differential diagnoses of tumors. The most common tumor of BP is metastasis. The most common primary tumor of BP is neurofibroma, which is visible as fusiform thickening of a nerve. In its solitary state, it may be challenging to differentiate from a schwannoma. The most common MRI finding is a neurogenic variant of thoracic outlet syndrome with an asymmetry of signal and thickness of the BP with edema. In abduction, a loss of fat directly related to the BP may be seen. Diffusion tensor imaging is a promising novel MRI sequences; however, the small diameter of the nerves contributing to the BP and susceptibility to artifacts may be challenging in obtaining sufficiently high-quality images.</p>}},
  author       = {{Szaro, Pawel and McGrath, Alexandra and Ciszek, Bogdan and Geijer, Mats}},
  issn         = {{2352-0477}},
  keywords     = {{Brachial plexus; Compression; Injury; Neuropathy; Tumor}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Radiology Open}},
  title        = {{Magnetic resonance imaging of the brachial plexus. Part 1 : Anatomical considerations, magnetic resonance techniques, and non-traumatic lesions}},
  url          = {{http://dx.doi.org/10.1016/j.ejro.2021.100392}},
  doi          = {{10.1016/j.ejro.2021.100392}},
  volume       = {{9}},
  year         = {{2022}},
}