Contribution of MRI to the Diagnosis and Classification of Brachial Plexus Injuries

Abstract

Background: The incidence of brachial plexus injuries (BPI) has increased due to the rise in sports and motor vehicle accidents. Accurate diagnosis through detailed clinical examination followed by magnetic resonance imaging (MRI) is crucial for effective management. Objective: This study aims to evaluate the diagnostic accuracy of MRI in patients with BPI and to determine the optimal timing and indications for MRI in these patients. Methods: A study was conducted on 30 patients with BPI. Patients presenting with flail upper limbs or suspected root avulsions underwent immediate MRI, while those without these indications had MRI after a delay of 4-6 weeks. MRI was utilized to differentiate between pre-ganglionic and post-ganglionic injuries, as well as mixed injuries, which is vital for determining the timing and type of surgical intervention. Results: MRI effectively distinguished between pre-ganglionic and post-ganglionic injuries, aiding in the appropriate surgical planning. We recommend MRI scans of the entire upper limb to assess edematous muscles and diaphragm movement patterns. Contrast studies can also be beneficial if not contraindicated. Conclusion: MRI is a valuable tool in the diagnosis and management of BPI, helping to distinguish between different types of injuries and informing surgical decisions. Immediate MRI is recommended for patients with severe clinical indications, while a delayed MRI may be appropriate for others.