High-resolution ultrasonography for the diagnosis of brachial plexus root lesions.
The aim of this study was to investigate the feasibility of using high-resolution ultrasonography in the diagnosis of brachial plexus (BP) root lesions. A prospective study of ultrasonographic evaluation of BP nerve roots was performed in 37 patients with BP root lesions (29 with root injuries, 8 with tumors). The pre-operative ultrasonographic findings were compared with the surgical and pathohistological findings. All C5-7 roots were detected by ultrasonography in all patients, whereas 92% (68/74) of C8 and 51% (38/74) of T1 nerve roots were visualized. Among 29 patients with BP root avulsion, partial injuries or totally interrupted BP roots were detected in all patients. Cystic masses and neuromas were detected in 16 and 23 patients, respectively. In 8 patients with BP root tumors, 8 hypo-echoic masses were detected inside or partly outside of intervertebral foramina connecting to nerve roots. Surgical exploration revealed that there were 57 BP root avulsions in 29 patients. However, 2 T1 nerve root avulsions had been missed by pre-operative ultrasonography. Pathohistology revealed that all 8 BP root tumors pre-operatively diagnosed by ultrasonography were schwannomas. High-resolution ultrasonography can provide a convenient and accurate imaging modality for quick diagnosis and location of BP root lesions.
Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xi'An, China.
Yong-Sheng
YS
Zhu
Department of Ultrasonography, General Hospital of Jinan Military Area Command of Chinese PLA, Ji'Nan, China.
Nan-Nan
NN
Mu
Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xi'An, China.
Min-Juan
MJ
Zheng
Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xi'An, China.
Yun-Chu
YC
Zhang
Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xi'An, China.
Hua
H
Feng
Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'An, China.
Rui
R
Cong
Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xi'An, China.
Xiao-Dong
XD
Zhou
Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xi'An, China. Electronic address: Xjyyzhu@gmail.com.
Ding-Zhang
DZ
Chen
D000328:Adult; D000465:Algorithms; D001917:Brachial Plexus / Q000000981:diagnostic imaging* / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D059348:Peripheral Nerve Injuries / Q000000981:diagnostic imaging*; D010524:Peripheral Nervous System Neoplasms / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
Brachial plexus; Neurogenic tumor; Trauma; Ultrasonography