Skip to main content
Erschienen in: European Radiology 6/2018

09.01.2018 | Magnetic Resonance

MR neurography in traumatic, non-obstetric paediatric brachial plexopathy

verfasst von: Vaishali Upadhyaya, Divya Narain Upadhyaya, Brijesh Mishra

Erschienen in: European Radiology | Ausgabe 6/2018

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Many studies have elaborated on the role of magnetic resonance neurography (MRN) in evaluating traumatic brachial plexopathies. Most of these deal with MR findings in adult traumatic plexopathies or children with obstetric brachial plexus palsy (OBPP). Hence, the authors felt the need for this particular study, which focuses on MRN findings in children with non-obstetric traumatic brachial plexus palsy, to find out the distribution and severity of injuries in these patients.

Methods

This was a single-institution, prospective study conducted between April 2015 and June 2016. All children presenting to the hospital with features of brachial plexopathy and a history of non-obstetric trauma were included in the study.

Results

At MRN, we looked for signs of injury at three levels: roots, trunks and cords. Signs of injury were found at the level of the roots in 22 patients (88%), at the level of the trunks in 20 patients (80%) and at the level of the cords in 22 patients (88%).

Conclusions

This study, conducted on children suffering from non-obstetric, traumatic brachial plexopathy returned some interesting conclusions including that when the paediatric plexus is injured, the injury is severe and multi-level, with a very high incidence of root injuries.

Key Points

Brachial plexus injury in paediatric age group is a devastating injury.
The most common cause of this is trauma sustained during birth.
Other causes include road traffic accidents and blunt injury.
MR neurography has revolutionised the diagnosis of brachial plexopathy
Literatur
1.
Zurück zum Zitat Chuang DC (2013) Brachial plexus injuries: Adult and pediatric. In: Neligan PC, Chang J (eds) Plastic Surgery, 3rd edn. Elsevier Saunders, London, pp 789–816 Chuang DC (2013) Brachial plexus injuries: Adult and pediatric. In: Neligan PC, Chang J (eds) Plastic Surgery, 3rd edn. Elsevier Saunders, London, pp 789–816
2.
Zurück zum Zitat John TJ (1999) IAP Policy on Age of Children for Pediatric Care. Indian Pediatr 36:461–463 John TJ (1999) IAP Policy on Age of Children for Pediatric Care. Indian Pediatr 36:461–463
3.
Zurück zum Zitat Mallouhi A, Marik W, Prayer D, Kainberger F, Bodner G, Kasprian G (2012) 3T MR tomography of the brachial plexus: Structural and microstructural evaluation. Eur J Radiol 81:2231–2245CrossRefPubMed Mallouhi A, Marik W, Prayer D, Kainberger F, Bodner G, Kasprian G (2012) 3T MR tomography of the brachial plexus: Structural and microstructural evaluation. Eur J Radiol 81:2231–2245CrossRefPubMed
4.
Zurück zum Zitat Chhabra A, Thawait GK, Soldatos T, Thakkar RS, Del Grande F, Chalian M et al (2013) High-resolution 3T MR neurography of the brachial plexus and its branches, with emphasis on 3D imaging. AJNR Am J Neuroradiol 34:486–497CrossRefPubMed Chhabra A, Thawait GK, Soldatos T, Thakkar RS, Del Grande F, Chalian M et al (2013) High-resolution 3T MR neurography of the brachial plexus and its branches, with emphasis on 3D imaging. AJNR Am J Neuroradiol 34:486–497CrossRefPubMed
5.
Zurück zum Zitat Lutz AM, Gold G, Beaulieu C (2014) MR imaging of the brachial plexus. Neuroimaging Clin N Am 24:91–108CrossRefPubMed Lutz AM, Gold G, Beaulieu C (2014) MR imaging of the brachial plexus. Neuroimaging Clin N Am 24:91–108CrossRefPubMed
6.
Zurück zum Zitat Yoshikawa T, Hayashi N, Yamamoto S, Tajiri Y, Yoshioka N, Masumoto T et al (2006) Brachial plexus injury: Clinical manifestations, conventional imaging findings, and the latest imaging techniques. Radiographics 26:s133–s143CrossRefPubMed Yoshikawa T, Hayashi N, Yamamoto S, Tajiri Y, Yoshioka N, Masumoto T et al (2006) Brachial plexus injury: Clinical manifestations, conventional imaging findings, and the latest imaging techniques. Radiographics 26:s133–s143CrossRefPubMed
7.
Zurück zum Zitat Abul-Kasim K, Backman C, Björkman A, Dahlin LB (2010) Advanced radiological work-up as an adjunct to decision in early reconstructive surgery in brachial plexus injuries. J Brachial Plex Peripher Nerve Inj 5:14PubMedPubMedCentral Abul-Kasim K, Backman C, Björkman A, Dahlin LB (2010) Advanced radiological work-up as an adjunct to decision in early reconstructive surgery in brachial plexus injuries. J Brachial Plex Peripher Nerve Inj 5:14PubMedPubMedCentral
8.
Zurück zum Zitat Upadhyaya V, Upadhyaya DN, Kumar A, Gujral RB (2015) MR neurography in traumatic brachial plexopathy. Eur J Radiol 84:927–932CrossRefPubMed Upadhyaya V, Upadhyaya DN, Kumar A, Gujral RB (2015) MR neurography in traumatic brachial plexopathy. Eur J Radiol 84:927–932CrossRefPubMed
9.
Zurück zum Zitat Upadhyaya V, Upadhyaya DN, Kumar A, Pandey AK, Gujral R, Singh AK (2015) Magnetic resonance neurography of the brachial plexus. Indian J Plast Surg 48:129–137CrossRefPubMedPubMedCentral Upadhyaya V, Upadhyaya DN, Kumar A, Pandey AK, Gujral R, Singh AK (2015) Magnetic resonance neurography of the brachial plexus. Indian J Plast Surg 48:129–137CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Silbermann-Hoffman O, Teboul F (2013) Post-traumatic brachial plexus MRI in practice. Diagn Interv Imaging 94:925–943CrossRefPubMed Silbermann-Hoffman O, Teboul F (2013) Post-traumatic brachial plexus MRI in practice. Diagn Interv Imaging 94:925–943CrossRefPubMed
11.
Zurück zum Zitat Hems TEJ, Birch R, Carlstedt T (1999) The role of magnetic resonance imaging in the management of traction injuries to the adult brachial plexus. J Hand Surg [Br] 24(5):550–555CrossRef Hems TEJ, Birch R, Carlstedt T (1999) The role of magnetic resonance imaging in the management of traction injuries to the adult brachial plexus. J Hand Surg [Br] 24(5):550–555CrossRef
12.
Zurück zum Zitat Du R, Auguste KI, Chin CT, Engstrom JW, Weinstein PR (2010) Magnetic resonance neurography for the evaluation of peripheral nerve, brachial plexus, and nerve root disorders. J Neurosurg 112:362–371CrossRefPubMed Du R, Auguste KI, Chin CT, Engstrom JW, Weinstein PR (2010) Magnetic resonance neurography for the evaluation of peripheral nerve, brachial plexus, and nerve root disorders. J Neurosurg 112:362–371CrossRefPubMed
13.
Zurück zum Zitat Tharin BD, Kini JA, York GE, Ritter JL (2014) Brachial Plexopathy: A Review of Traumatic and Nontraumatic Causes. AJR 202:W67–W75CrossRefPubMed Tharin BD, Kini JA, York GE, Ritter JL (2014) Brachial Plexopathy: A Review of Traumatic and Nontraumatic Causes. AJR 202:W67–W75CrossRefPubMed
14.
Zurück zum Zitat Somashekar D, Yang LJS, Ibrahim M, Parmar HA (2014) High-resolution MRI evaluation of neonatal brachial plexus palsy: A promising alternative to traditional CT myelography. AJNR Am J Neuroradiol 35:1209–1213CrossRefPubMed Somashekar D, Yang LJS, Ibrahim M, Parmar HA (2014) High-resolution MRI evaluation of neonatal brachial plexus palsy: A promising alternative to traditional CT myelography. AJNR Am J Neuroradiol 35:1209–1213CrossRefPubMed
15.
Zurück zum Zitat van Ouwerkerk W (2005) JR. Preoperative Investigations in Obstetric Brachial Plexus Palsy. Semin Plast Surg. 19(1):17–23CrossRefPubMedCentral van Ouwerkerk W (2005) JR. Preoperative Investigations in Obstetric Brachial Plexus Palsy. Semin Plast Surg. 19(1):17–23CrossRefPubMedCentral
16.
Zurück zum Zitat Abbott R, Abbott M, Alzate J, Lefton D (2004) Magnetic resonance imaging of obstetrical brachial plexus injuries. Childs Nerv Syst 20(10):720–725PubMed Abbott R, Abbott M, Alzate J, Lefton D (2004) Magnetic resonance imaging of obstetrical brachial plexus injuries. Childs Nerv Syst 20(10):720–725PubMed
17.
Zurück zum Zitat Menashe SJ, Tse R, Nixon JN, Ishak GE, Thapa MM, McBroom JA et al (2015) Brachial Plexus Birth Palsy: Multimodality Imaging of Spine and Shoulder Abnormalities in Children. AJR Am J Roentgenol 204:W199–W206 Menashe SJ, Tse R, Nixon JN, Ishak GE, Thapa MM, McBroom JA et al (2015) Brachial Plexus Birth Palsy: Multimodality Imaging of Spine and Shoulder Abnormalities in Children. AJR Am J Roentgenol 204:W199–W206
18.
Zurück zum Zitat Smith AB, Gupta N, Strober J, Chin C (2008) Magnetic resonance neurography in children with birth-related brachial plexus injury. Pediatr Radiol 38(2):159–163CrossRefPubMed Smith AB, Gupta N, Strober J, Chin C (2008) Magnetic resonance neurography in children with birth-related brachial plexus injury. Pediatr Radiol 38(2):159–163CrossRefPubMed
19.
20.
Zurück zum Zitat Songcharoen P (1995) Brachial plexus injury in Thailand: A report of 520 cases. Microsurgery 16:35–39CrossRefPubMed Songcharoen P (1995) Brachial plexus injury in Thailand: A report of 520 cases. Microsurgery 16:35–39CrossRefPubMed
21.
Zurück zum Zitat Jain DKA, Bhardwaj P, Venkatramani H, Sabapathy SR (2012) An epidemiological study of traumatic brachial plexus injury patients treated at an Indian centre. Indian J PlastSurg 45(3):498–503 Jain DKA, Bhardwaj P, Venkatramani H, Sabapathy SR (2012) An epidemiological study of traumatic brachial plexus injury patients treated at an Indian centre. Indian J PlastSurg 45(3):498–503
22.
Zurück zum Zitat Thatte MR, Babhulkar S, Hiremath A (2013) Brachial plexus injury in adults: Diagnosis and surgical treatment strategies. Ann Indian Acad Neurol 16:26–33CrossRefPubMedPubMedCentral Thatte MR, Babhulkar S, Hiremath A (2013) Brachial plexus injury in adults: Diagnosis and surgical treatment strategies. Ann Indian Acad Neurol 16:26–33CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Songcharoen P (2008) Management of brachial plexus injury in adults. Scand J of Surg. 97:317–323CrossRef Songcharoen P (2008) Management of brachial plexus injury in adults. Scand J of Surg. 97:317–323CrossRef
24.
Zurück zum Zitat Moran SL, Steinmann SP, Shin AY (2005) Adult brachial plexus injuries: Mechanism, patterns of injury, and physical diagnosis. Hand Clin 21:13–24CrossRefPubMed Moran SL, Steinmann SP, Shin AY (2005) Adult brachial plexus injuries: Mechanism, patterns of injury, and physical diagnosis. Hand Clin 21:13–24CrossRefPubMed
25.
Zurück zum Zitat Qin BG, Yang JT, Yang Y, Wang HG, Fu G, Gu LQ et al (2016) Diagnostic Value and Surgical Implications of the 3D DW-SSFP MRI On the Management of Patients with Brachial Plexus Injuries. Scientific Reports 6:35999CrossRefPubMedPubMedCentral Qin BG, Yang JT, Yang Y, Wang HG, Fu G, Gu LQ et al (2016) Diagnostic Value and Surgical Implications of the 3D DW-SSFP MRI On the Management of Patients with Brachial Plexus Injuries. Scientific Reports 6:35999CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Van der Linde E, Naidu V, Mitha A, Rocher A (2015) Diagnosis of nerve root avulsion injuries in adults with traumatic brachial plexopathies: MRI compared with CT myelography. S Afr J Rad 19(1):779 9 pages Van der Linde E, Naidu V, Mitha A, Rocher A (2015) Diagnosis of nerve root avulsion injuries in adults with traumatic brachial plexopathies: MRI compared with CT myelography. S Afr J Rad 19(1):779 9 pages
27.
Zurück zum Zitat Mikityansky I, Zager EL, Yousem DM, Loevner LA (2012) MR Imaging of the Brachial Plexus. Magn Reson Imaging Clin N Am 20:791–826CrossRefPubMed Mikityansky I, Zager EL, Yousem DM, Loevner LA (2012) MR Imaging of the Brachial Plexus. Magn Reson Imaging Clin N Am 20:791–826CrossRefPubMed
Metadaten
Titel
MR neurography in traumatic, non-obstetric paediatric brachial plexopathy
verfasst von
Vaishali Upadhyaya
Divya Narain Upadhyaya
Brijesh Mishra
Publikationsdatum
09.01.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 6/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5217-x

Weitere Artikel der Ausgabe 6/2018

European Radiology 6/2018 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.