Diagnostic performance of ultrasound in patients with suspected brachial plexus lesions in adults: a multicenter retrospective study with MRI, surgical findings and clinical follow-up as reference standard.
OBJECTIVE
To evaluate brachial plexus ultrasound (US) performance in a large multicenter study.


METHODS
The research was approved by the Institutional Review Boards, and all patients gave written informed consent. A multicenter retrospective trial including three centers was performed between March, 2006 and April, 2011. A total of 204 patients who received a brachial plexus ultrasound requested by the referring physician were enrolled: magnetic resonance imaging, surgical findings and clinical follow-up of at least 12 months were used as the reference standard. Sensitivity, specificity with 95 % confidence intervals (CIs), positive predictive value (PPV), pre-test-probability (the prevalence), negative predictive value (NPV), pre- and post- test odds (OR), likelihood ratio for positive results (LH+), likelihood ratio for negative results (LH-), accuracy and post-test probability (post-P) were reported on a per-patient basis.


RESULTS
The overall sensitivity and specificity with 95 % CIs were: 0.76 (0.75-0.97); 0.96 (0.77-0.89). Overall PPV, pre-test probability, NPV, pre-OR, post-OR, LH+, LH-, Accuracy and post-P were: 0.93/0.43/0.84/0.75/0.75/13.4/17.6/0.25/0.88/0.93, respectively.


CONCLUSIONS
The specificity of brachial plexus US in patients suspected of having a brachial plexus lesion is very high.
Department of Human Anatomy, DIMES, Università di Genova, Genoa, Italy. atagliafico@sirm.org
Alberto
A
Tagliafico
Giulia
G
Succio
Giovanni
G
Serafini
Carlo
C
Martinoli
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001917:Brachial Plexus / Q000000981:diagnostic imaging* / Q000473:pathology*; D020516:Brachial Plexus Neuropathies / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000706:statistics & numerical data*; D055815:Young Adult