CT of the brachial plexus in patients with cancer

To assess the usefulness of CT, we reviewed 51 patients with clinically diagnosed brachial plexopathy who were seen between 1977 and 1981. The established etiology was metastatic tumor in 46 and radiation fibrosis in 5. CT was abnormal in 89% of tumor patients. Myelography, bone scan, and plain cervical spine radiographs were less useful. In four of five patients with radiation fibrosis, CT showed distortion of normal tissue planes without a discrete mass, but was not always distinguishable from tumor infiltration. CT of the brachial plexus provides the best two-dimensional view of tumor infiltration and detects bony changes earlier than standard radiographs. CT is a useful guide for surgical exploration of the brachial plexus, but does not differentiate tumor infiltration from radiation fibrosis.