Brachial Plexus

Naoki Takahashi1, Vamsidhar Narra1

1 Mallinckrodt Institute of Radiology, Washington University Medical Center, St. Louis, Missouri
Publication Name:  Current Protocols in Magnetic Resonance Imaging
Unit Number:  Unit A14.1
DOI:  10.1002/0471142719.mia1401s00
Online Posting Date:  May, 2001
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Abstract

MRI is the primary imaging modality used to diagnose the cause of brachial plexopathy. This unit presents protocols to diagnose the cause of brachial plexus. The provides the core component of this procedure and an alternate protocol is presented for the case of avulsion injury from trauma. A second alternate protocol is presented for the case where neoplastic involvement of the brachial plexus is suspected or any abnormalities are seen. A third alternate protocol is presented for the cases when the patient has symptoms of thoracic outlet syndrome and vascular compression is suspected.

     
 
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Table of Contents

  • Basic Protocol 1: Imaging of Brachial Plexus
  • Alternate Protocol 1: Imaging of Brachial Plexus for Avulsion Injury
  • Alternate Protocol 2: Imaging of Brachial Plexus for Neoplastic Involvement
  • Alternate Protocol 3: Contrast‐Enhanced MRA for Thoracic Outlet Syndrome
  • Commentary
  • Figures
  • Tables
     
 
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Materials

Basic Protocol 1: Imaging of Brachial Plexus

  Materials
  • Normal saline (0.9% NaCl), sterile
  • Gadolinium‐based MR contrast agent (e.g., Magnevist, Omniscan, or Prohance) 22‐G intravenous catheter
  • Power injector (optional)

Alternate Protocol 1: Imaging of Brachial Plexus for Avulsion Injury

  Materials
  • Normal saline (0.9% NaCl), sterile
  • Gadolinium‐based MR contrast agent (e.g., Magnevist, Omniscan, or Prohance)
  • Power injector (for the MRA technique)
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Figures

Videos

Literature Cited

Literature Cited
   Bowen, B.C., Verma, A., Brandon, A.H., and Fiedler, J.A. 1996. Radiation induced brachial plexopathy: MR imaging with clinical correlation. Am. J. Neuroradiol. 17:1932‐1936.
   Glazer, H.S., Lee, J.K.T., Levitt, R.G., Heiken, J.P., Ling, D., Totty, W.G., Balfe, D.M., Emani, B., Wasserman, T.H., and Murphy, W.A. 1985. Radiation fibrosis: Differentiation from recurrent tumor by MR imaging—work in progress. Radiology 156:721‐726.
   Posniak, H.V., Olson, M.C., Dudiak, C.M., Wisniewski, R., and O'Malley, C. 1993. MR imaging of the brachial plexus. Am. J. R Roentgenol. 161:373‐379.
   Shellock, F.G. 1996. Pocket Guide to MR Procedures and Metallic Objects. Lippincott‐Raven, Philadelphia.
   Thyagarajan, D., Cascino, T., and Harms, G. 1995. Magnetic resonance imaging in brachial plexopathy of cancer. Neurology 45:421‐427.
   Wittenberg, K.H. and Adkins, M.C. 2000. MR imaging of nontraumatic brachial plexopathies: frequency and spectrum of findings. Radiographics 20:1023‐1032.
Key References
   Posniak et al., 1993. See above.
  Covers overview of MR appearances of various diseases involving brachial plexus.
   Shellock, 1996. See above.
  Covers a number of important patient management issues related to MR imaging, including recommended safety procedures, a list of metallic implants that have been tested for MR compatibility, and a list of other sources on MR safety.
   Wittenberg and Adkins 2000. See above.
  Covers overview of MR appearances of various diseases involving brachial plexus.
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