Diagnostic Performance of Short MR-Neurography Protocol for Brachial Plexus Injuries

Authors

  • Siriwan Piyapittayanan Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Natthawut Jarunnarumol Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Panai Laohaprasitiporn Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Suthon Noiwatana Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Orasa Chawalparit Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0001-7073-3750

Keywords:

MR-neurography; high-resolution MRI; brachial plexus injury; nerve root avulsion

Abstract

Objective: To study the diagnostic performance of MR neurography (MRN) for brachial plexus injuries and to optimize the protocol using clinical contexts as the reference standard.
Methods: There were 21 patients with brachial plexus injury who were scheduled for conventional myelography. A brachial plexus MRN including T2-weighted image-high resolution (T2WI/HR), mDIXON and diffusion weighted image was performed prior to a conventional myelography on the same day. The results of the conventional
myelography and the MR imaging were recorded and compared, with the clinical contexts as the reference standard. The sensitivities, specificities, accuracies, false positive and false negative were calculated and compared.
Results: The accuracy, sensitivity, specificity, false positive and false negative of the conventional myelography were 69.52%, 73.61%, 60.61%, 19.70% and 48.72%, respectively. The diagnostic performance of T2WI/HR were 72.00%, 78.26%, 58.06%, 19.40% and 45.45% for T2WI/HR, respectively which were comparable to those of conventional myelography. The accuracy, sensitivity, specificity, false positive and false negative of the combination of T2WI/HR and mDIXON were 78.00%, 97.10%, 35.48%, 22.99% and 15.38%, respectively which yielded the highest accuracy.
Conclusion: MRN with the combination of T2WI/HR and mDIXON was superior to conventional myelography for the evaluation of brachial plexus injuries due to its shorter processing time, the lack of a need for contrast medium administration, its noninvasive nature, and the provision of information about both preganglionic and
postganglionic injuries.

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Published

24-07-2019

How to Cite

Piyapittayanan, S., Jarunnarumol, N., Laohaprasitiporn, P., Noiwatana, S., & Chawalparit, O. (2019). Diagnostic Performance of Short MR-Neurography Protocol for Brachial Plexus Injuries. Siriraj Medical Journal, 71(4), 284–289. Retrieved from https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/205213

Issue

Vol. 71 No. 4 (2019): July-August

Section

Original Article

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