title: Clinical impact of magnetic resonance neurography in patients with brachial plexus neuropathies.
abstract: OBJECTIVE
  To study the impact of brachial plexus MR neurography (MRN) in the diagnostic thinking and therapeutic management of patients with suspected plexopathy.
  
  
  METHODS
  MRN examinations of adult brachial plexuses over a period of 18 months were reviewed. Relevant data collection included-patient demographics, clinical history, pre-imaging diagnostic impression, pre-imaging treatment plan, post-imaging diagnosis, post-imaging treatment plan, surgical notes and electrodiagnostic (ED) results. Impact of imaging on the pre-imaging clinical diagnosis and therapeutic management were classified as no change, mild change or substantial change.
  
  
  RESULTS
  Final sample included 121 studies. The common aetiologies included inflammatory in 31 (25.6%) of 121 patients, trauma in 29 (23.9%) of 121 patients and neoplastic in 26 (21.5%) of 121 patients. ED tests were performed in 47 (38.8%) of 121 patients and these showed concordance with MRN findings in 31 (66.0%) of 47 patients. Following MRN, there was change in the pre-imaging clinical impression for 91 (75.2%) of 121 subjects, with a mild change in diagnosis in 57 (47.1%) of 121 patients and a substantial change in 34 (28.0%) of 121 patients. 19 (15.7%) of 121 patients proceeded to therapies that would not have been performed in the same manner without the information obtained from MRN.
  
  
  CONCLUSIONS
  MRN of the brachial plexus significantly impacts clinical decision-making and should be routinely performed in suspected brachial plexopathy. Advances in knowledge: MRN significantly impacts the diagnostic thinking and therapeutic management of patients with suspected brachial plexopathy. MRN not only provides concordant information to ED tests in majority of cases, but also supplements with additional diagnostic data in patients who are ED negative.
authors: 1 Musculoskeletal Imaging Division, Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.
authors: Stephen
authors: S
authors: Fisher
authors: 2 Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors: Vibhor
authors: V
authors: Wadhwa
authors: 1 Musculoskeletal Imaging Division, Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.
authors: Christine
authors: C
authors: Manthuruthil
authors: 3 Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
authors: Jonathan
authors: J
authors: Cheng
authors: 1 Musculoskeletal Imaging Division, Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.
authors: Avneesh
authors: A
authors: Chhabra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020516:Brachial Plexus Neuropathies / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged