Magnetic resonance imaging in children with obstetric brachial plexus injury
Main Article Content
Abstract
Obstetric brachial plexus injury is a co mmon injury in children. The traditional method of diagnosis depends on physical examination and electromyography. Three Tesla magnetic resonance imaging (3T MRI) is a new tool for identification of lesions of the obstetric brachial plexus in children. Our goal was to assess the effectiveness of 3T MRI in diagnosis. Seventy - five patients underwent 3T MRI. The result showed that all of the plexus was displayed with good quality (3.1 ± 0,25 points on T1W and 3.9 ± 0,11 points on T2W, STIR and CISS). All roots C5, C6 were damaged, in which the predominance damage was of Sunderland degree IV and V. Roots C7, C8 had lower frequency of damage and mostly were of degree V. In the damaged roots, the rate of root alvusion was 34%, pseudomeningoceles was 32.3%, neuroma was 40,2%, and diffuse edema was 94.8%. In conclusion, 3T MRI is a noninvasive diagnostic method that can be used to assess and classify lesions in obstetrical brachial plexus palsy for prognosis and treatment planning.
Article Details
Keywords
Obstetric brachial plexus injury, 3T MRI, Erb's palsy
References
2. Lalka A, Gralla J, Sibbel SE. Brachial Plexus Birth Injury: Epidemiology and Birth Weight Impact on Risk Factors. J Pediatr Orthop. 2020;40 (6):e460 - e465.
3. Van der Looven R, Le Roy L, Tanghe E, et al. Risk factors for neonatal brachial plexus palsy: a systematic review and meta - analysis. Dev Med Child Neurol. 2020;62 (6):673 - 683.
4. Lagerkvist AL, Johansson U, Johansson A, Bager B, Uvebrant P. Obstetric brachial plexus palsy: a prospective, population - based study of incidence, recovery, and residual impairment at 18 months of age. Dev Med Child Neurol. 2010;52 (6):529 - 534.
5. Pondaag W, Malessy MJ, van Dijk JG, Thomeer RT. Natural history of obstetric brachial plexus palsy: a systematic review. Dev Med Child Neurol. 2004;46 (2):138 - 144.
6. Chauhan SP, Blackwell SB, Ananth CV. Neonatal brachial plexus palsy: incidence, prevalence, and temporal trends. Semin Perinatol. 2014;38 (4):210 - 218.
7. Tagliafico A, Succio G, Emanuele Neumaier C, et al. MR imaging of the brachial plexus: comparison between 1.5 - T and 3 - T MR imaging: preliminary experience. Skeletal Radiol. 2011;40 (6):717 - 724.
8. Lee SK, Wolfe SW. Peripheral nerve injury and repair. J Am Acad Orthop Surg. 2000;8 (4):243 - 252.
9. Chhabra A, Ahlawat S, Belzberg A, Andreseik G. Peripheral nerve injury grading simplified on MR neurography: As referenced to Seddon and Sunderland classifications. Indian
J Radiol Imaging. 2014;24 (3):217 - 224.
10, Yoshikawa T, Hayashi N, Yamamoto S, et al. Brachial plexus injury: clinical
manifestations, conventional imaging findings, and the latest imaging techniques. Radiographics. 2006;26 Suppl 1:S133 - 143.
11. Gasparotti R, Ferraresi S, Pinelli L, et al. Three - dimensional MR myelography of traumatic injuries of the brachial plexus. AJNR Am J Neuroradiol. 1997;18 (9):1733 - 1742.
12. Tsai PY, Chuang TY, Cheng H, Wu HM, Chang YC, Wang CP. Concordance and discrepancy between electrodiagnosis and magnetic resonance imaging in cervical root avulsion injuries. J Neurotrauma. 2006;23 (8):1274 - 1281.
13. Gasparotti R, Lodoli G, Meoded A, Carletti F, Garozzo D, Ferraresi S. Feasibility of diffusion tensor tractography of brachial plexus injuries at 1.5 T. Invest Radiol. 2013;48 (2):104 - 112.
14. Hayashi N, Masumoto T, Abe O, Aoki S, Ohtomo K, Tajiri Y. Accuracy of abnormal paraspinal muscle findings on contrast - enhanced MR images as indirect signs of unilateral cervical root - avulsion injury. Radiology. 2002;223 (2):397 - 402.
15. Andreisek G, Burg D, Studer A, Weishaupt D. Upper extremity peripheral neuropathies: role and impact of MR imaging on patient management. Eur Radiol. 2008;18 (9):1953 - 1961.