Brachial plexus traumatic root injury in adults: Role of different non contrast MRI sequences in pre-operative assessment

Abstract

Aim of the work: To evaluate the role of fast imaging employing steady-state acquisition (FIESTA) together with conventional MRI and MR myelography (MRM) sequences in evaluation of brachial plexus traumatic roots injury in adults in correlation with surgical outcome. Subjects and methods: This prospective study included 20 patients (their mean age was 22.6 years). All patients came with initial clinical diagnosis of traumatic brachial plexus and positive electrodiagnostic tests. All underwent conventional MRI, FIESTA and MRM and the imaging findings were correlated with surgical outcome. Results: Combined evaluation of the conventional MRI, FIESTA and MRM sequences yielded highest diagnostic sensitivity (95%) of pseudomeningocele and non-visualized nerve root detection which are the most important marks of brachial plexus root injury compared to conventional MRI combined with FIESTA (90%) and to conventional MRI combined with myelography (85%) Conclusion: In traumatic brachial plexus root injury, it is vital to differentiate between pre- and postganglionic injuries. Combined conventional MRI/FIESTA/MRM depicted root injury has the highest sensitivity in detection of psuesdomeningiocele and non-visualized nerve root.

Keywords

• Brachial plexus
• Root injury
• Psuesdomeningiocele
• FIESTA
• MR Myelography