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Chest Imaging

E3186. State-of-the-Art Imaging of the Brachial Plexus: Techniques and Disease Processes

Salem U,  Amini B,  Truong M,  Madewell J,  Carter B. MD Anderson Cancer Center, Houston, TX

Address correspondence to U. Salem (usalem@mdanderson.org)

Background Information: Our objective is to review the anatomy of the brachial plexus with MRI correlation and discuss the role of imaging in the evaluation of the brachial plexus. We will also review the disease processes that may affect the brachial plexus and describe their characteristic imaging features. Finally, we will summarize future directions and new techniques in imaging of the brachial plexus.

Educational Goals/Teaching Points: The brachial plexus arises from the ventral roots of the cervicothoracic spine and provides the motor and sensory supply to the upper limbs. A wide variety of disease processes may adversely affect the brachial plexus, including trauma, malignancy, radiation therapy, infection, inflammation, and vascular abnormalities. Identifying the precise cause and location of brachial plexus injury is crucial for appropriate therapy; however, this can be problematic given its location and the inherent limitations of imaging this anatomic region. Therefore, an understanding of brachial plexus anatomy and the role of specific imaging techniques is necessary for radiologists to guide patient management. Several new MRI techniques are currently under investigation, including 3D MRI, MR myelography, diffusion-weighted neurography, and MR spectroscopy.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: The normal anatomy of the brachial plexus will be reviewed using illustrations with MRI correlation. Different disease processes involving the brachial plexus will be discussed in a case-based style, providing the salient imaging findings for diagnosis.

Conclusion: The brachial plexus provides the motor and sensory supply to the upper limbs, and has a complex anatomy, which is best identified by MRI. A wide variety of disease processes may affect the brachial plexus, and identifying the precise cause and location of brachial plexus injury is crucial for appropriate therapy. Several new MRI techniques are currently under investigation in an effort to decrease scan time and improve the quality of MR images.