The predictive value of high-resolution magnetic resonance imaging for brachial plexus injury

Cai Shanjun; Wang Guosong; Jiang Qian; Huang Jinjin

doi:10.11850/j.issn.1009-122X.2024.04.007

Abstract：Objective To explore the predictive value of high-resolution magnetic resonance imaging(MRI)for brachial plexus injury(BPI).Methods A total of 59 clinically suspected cases of BPI were evaluated using high-resolution MRI.These patients were divided into two groups based on age:individuals aged≥65 years were included in the elderly group,while those aged between 18 and 64 years were included in the middle-aged group.The imaging effects of the brachial plexus nerves in the two groups were observed,and the brachial plexus nerve imaging score,brachial plexus signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and background tissue inhibition scores were calculated.The predictive value of high-resolution MRI imaging for BPI in different age groups was analyzed.Results Among 59 clinically suspected cases of BPI,20 were diagnosed as BPI by MRI,while the remaining cases were normal.Among the 20 patients with BPI by MRI,there were 7 in the elderly group and 13 in the middle-aged group.In the elderly group,there were 2 cases(28.57%)of pre-ganglionic injury and 5(71.43%)of post-ganglionic injury.In the middle-aged group,there were 5(38.46%)of pre-ganglionic injury and 8(61.54%)of post-ganglionic injury.The brachial plexus imaging scores in the two groups of patients,from low to high,were sequentially 3D dual echo steady-state(3D-DESS)sequence enhanced scan,and 3D short time reversal recovery fast spin echo(3D SPACE)sequence plain scan,DESS sequence plain scan,and SPACE sequence enhanced scan.Moreover,on the trunk 3,branch 5 DESS sequence plain scan,branch 6 DESS sequence enhanced scan,and branch 5 SPACE sequence enhanced scan,the brachial plexus imaging score of the elderly group was significantly lower than that of the middle-aged group(P<0.05).The SNR and CNR of the two groups of brachial plexus nerves,from low to high,were in descending order:DESS enhancement,SPACE plain scan,DESS plain scan,and SPACE enhancement(P<0.05).In terms of comparison of the background tissue inhibition scores in the two groups,SPACE enhancement was the highest,followed by DESS plain scan,with DESS enhancement and SPACE plain scan being the lowest(P<0.05).The SNR and CNR of DESS sequence enhanced scan and both the SPACE sequence plain scan and enhanced scan were all significantly lower in the elderly group than that in the middle-aged group(P<0.05).Conclusions Compared to middle-aged patients with BPI,elderly BPI patients have lower brachial plexus imaging scores,SNR,and CNR.The MRI 3D SPACE sequence can clearly display the internal signal changes of the brachial plexus,while reducing the interference of background tissue signals around the nerves.It has a significant advantage in displaying nerve damage and is worth prioritizing in clinical practice.