title: Brachial plexus and nerves about the shoulder.
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.
authors.affiliation: Cattedra di Radiologia-DISC, Università di Genova, Largo Rosanna Benzi 8, Genoa, Italy. carlo.martinoli@libero.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Martinoli
authors.forename: Nicola
authors.initials: N
authors.lastname: Gandolfo
authors.forename: Maribel Miguel
authors.initials: MM
authors.lastname: Perez
authors.forename: Andrea
authors.initials: A
authors.lastname: Klauser
authors.forename: Federigo
authors.initials: F
authors.lastname: Palmieri
authors.forename: Luca
authors.initials: L
authors.lastname: Padua
authors.forename: Alberto
authors.initials: A
authors.lastname: Tagliafico
mesh_terms: D001917:Brachial Plexus / Q000000981:diagnostic imaging* / Q000473:pathology*; D020968:Brachial Plexus Neuritis / Q000000981:diagnostic imaging / Q000473:pathology; D020516:Brachial Plexus Neuropathies / Q000000981:diagnostic imaging* / Q000473:pathology*; D003287:Contrast Media; D017352:Echo-Planar Imaging / Q000379:methods; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D012782:Shoulder / Q000000981:diagnostic imaging / Q000294:innervation / Q000473:pathology; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000294:innervation / Q000473:pathology*; D013901:Thoracic Outlet Syndrome / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D005682:Gadolinium