title: Differential diagnosis between pre- and postganglionic adult traumatic brachial plexus lesions by ultrasonography.
abstract: The goal of this study was to prospectively investigate the feasibility of preoperative ultrasonography evaluation in the differentiation between pre- and postganglionic traumatic brachial plexus lesions. Two expert radiologists employed ultrasonography to observe the morphology of the brachial plexus in 23 patients with suspected traumatic brachial plexus lesions and 40 healthy volunteers. The detection rate was 100% (126/126) for the C5 through C7 nerve roots and upper and middle trunks and three fascicles, 84% (106/126) for the C8 roots and the lower trunks and 64% (81/126) for T1 roots in all subjects. Surgical inspections found 58 lesions in 23 patients (40 preganglionic lesions and 18 postganglionic lesions). Ultrasonography detected most of the brachial plexus lesions (56/58) but misjudged two preganglionic and two postganglionic lesions. The rate of differentiation was 93% (52/56). This study demonstrated that ultrasonography is a useful but experience-dependent supplemental imaging technique for preoperative diagnosis of brachial plexus lesions and differentiation between pre- and postganglionic brachial plexus lesions.
authors.affiliation: Department of Ultrasound, Xijing Hospital, Fourth Military Medical University Xi'an, China.
authors.forename: Ding-Zhang
authors.initials: DZ
authors.lastname: Chen
authors.forename: Rui
authors.initials: R
authors.lastname: Cong
authors.forename: Min-Juan
authors.initials: MJ
authors.lastname: Zheng
authors.forename: Ting
authors.initials: T
authors.lastname: Zhu
authors.forename: Garrett
authors.initials: G
authors.lastname: Coles
authors.forename: Hua
authors.initials: H
authors.lastname: Feng
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Zhou
authors.forename: Yong-Sheng
authors.initials: YS
authors.lastname: Zhu
mesh_terms: D000328:Adult; D001917:Brachial Plexus / Q000000981:diagnostic imaging / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000000981:diagnostic imaging* / Q000601:surgery; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D005727:Ganglia, Spinal / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D007430:Intraoperative Care; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography