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Scholars Journal of Applied Medical Sciences | Volume-3 | Issue-05
Role of MRI in Evaluation and Characterization of Brachial Plexopathies
Dr. Alka Agarwal, Dr. Abhinav Sahu, Dr. Awesh Gambre, Dr. P. S. Tripathi, Dr. Preety Kochar, Dr. Rituja Prakash
Published: Aug. 28, 2015 |
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DOI: 10.36347/sjams.2015.v03i05.031
Pages: 1949-1953
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Abstract
Brachial plexopathies are difficult to accurately diagnose, even with a meticulous investigation because the
anatomic design of the plexus pose challenges, and also because the types of lesions and injuries that occur are frequently
complex. Thus establishing a precise anatomic diagnosis and estimating the severity of the lesion is imperative for
prognostic, surgical, and rehabilitative purposes. Evaluation of the brachial plexus is a clinical challenge and clinical
examination and EMG (electrophysiological studies) provide only functional details without providing information
regarding lesion localization and characterisation. MRI is currently the imaging modality of choice for evaluation of
brachial plexus pathologies. MRI is valuable in identifying, localizing and characterizing the lesions affecting the
brachial plexus and in differentiating the various traumatic lesions into pre-ganglionic and post-ganglionic which is
critical for decision making and surgical planning, whether to proceed with exploration, nerve repair or nerve transfer. In
this study a total of 50 patients were taken out of these 28(56%) were traumatic and rest were non traumatic 22 (44%).
Amongst the traumatic lesions, post-ganglionic injuries(78.5%) were more common than pre-ganglionic(60.5%). Over all
stretch injury(64%) was the most common cause of traumatic brachial plexopathies. In our study MRI had an accuracy of
97.5% in cases of root avulsion with 100% accuracy in other traumatic lesions(pseudomeningocele and transected nerve)
whereas it was found to be 100% in nontraumatic brachial plexopathies such as primary and secondary tumors.