Magnetic Resonance Imaging Classification Using the Three-Dimensional T2-weighted SPACE Method for Brachial Plexus...

Area of Science:

• Neurology
• Radiology
• Orthopedic Surgery

Background:

• Traumatic brachial plexus injury (BPI) often involves complex intravertebral and extravertebral lesions.
• Accurate classification of preganglionic injuries is crucial for effective treatment planning.
• Three-dimensional T2-weighted SPACE (3D-T2-SPACE) MRI has shown promise in visualizing these injuries.

Purpose of the Study:

• To classify preganglionic injuries in BPI using 3D-T2-SPACE MRI findings.
• To evaluate the diagnostic validity of 3D-T2-SPACE MRI for intravertebral injuries in BPI.
• To correlate imaging findings with injury types and patient outcomes.

Main Methods:

• 206 BPI patients underwent 3D-T2-SPACE MRI.
• Intravertebral structures (spinal cord, rootlets, nerve roots, dorsal root ganglions) were assessed.
• Extravertebral lesions were evaluated using T2-STIR images for root continuity, signal changes, edema, hypertrophy, and displacement.

Main Results:

• Intravertebral lesions were classified into five types (M, A, B, C, N/D).
• Meningeal cysts, spinal edema, and rootlet absence were key indicators of preganglionic injuries.
• Type N/D, indicating potential for nerve repair, was more frequent in the C5 root and useful for surgical method selection.

Conclusions:

• 3D-T2-SPACE MRI enables detailed, noninvasive classification of preganglionic BPI.
• This classification supports accurate diagnosis and guides reconstructive procedures.
• It may reduce the need for surgical diagnostic exploration of the brachial plexus.