ABSTRACT
Ultrasound (US) and MR imaging have been shown able to detect in-depth features of
brachial plexus anatomy and to localize pathological lesions in disorders where electrophysiology
and physical findings are nonspecific or nonlocalizing. High-end gradient technology,
phased array coils, and selection of an appropriate protocol of pulse sequences are
the main requirements to evaluate the brachial plexus nerves with MR imaging and to
distinguish between intrinsic and extrinsic pathological changes. A careful scanning
technique based on anatomical landmarks is required to image the brachial plexus nerves
with US. In traumatic injuries, MR imaging and myelographic techniques can exclude
nerve lesions at the level of neural foramina and at intradural location. Outside
the spinal canal, US is an excellent alternative to MR imaging to determine the presence
of a lesion, to establish the site and the level of nerve involvement, as well as
to confirm or exclude major nerve injuries.
In addition to brachial plexus injuries, MR imaging and US can be contributory in
a variety of nontraumatic brachial plexopathies of a compressive, neoplastic, and
inflammatory nature. In the thoracic outlet syndrome, imaging performed in association
with postural maneuvers can help diagnose dynamic compressions. MR imaging and US
are also effective to recognize neuropathies about the shoulder girdle involving the
suprascapular, axillary, long thoracic, and spinal accessory nerves that may mimic
brachial plexopathy. In this article, the clinical entities just listed are discussed
independently, providing an overview of the current status of knowledge regarding
imaging assessment.
KEYWORDS
Brachial plexus - Parsonage-Turner syndrome - brachial plexopathies - thoracic outlet
syndrome - magnetic resonance imaging - ultrasound - MR myelography
REFERENCES
carlo.martinoli@libero.it
