Abstract
The authors described a modified pathological classification (PC) of brachial plexus
injury (BPI) and its magnetic resonance (MR) imaging characteristics. The reliability
and diagnostic accuracy of MR imaging for detecting nerve injury was discussed. Between
2006 and 2010, 86 patients with BPI were managed surgically in our department. Their
preoperative MR images and surgical findings were analyzed retrospectively. The PC
of BPI was classified into five types: (I) nerve root injury in continuity (including
Sunderland grade I–IV injury); (II) postganglionic spinal nerve rupture with or without
proximal stump; (III) preganglionic root injury (visible); (IV) preganglionic nerve
root injury and postganglionic spinal nerves injury; (V) preganglionic root injury
(invisible). The main MR imaging characteristics of BPI included traumatic meningocele,
displacement of spinal cord, the absence of nerve root, “Black line” sign, nerve root/trunk
injury in continuity, and thickening and edema of nerve root. The accuracy of MR imaging
for detecting C5, C6, C7, C8, and T1 nerve roots injury were 93.3, 95.2, 92.3, 84,
and 74.4%, respectively. The modified PC provides a detailed description of nerve
root injury in BPI, and MR imaging technique is a reliable method for detecting nerve
root injury.
Keywords
brachial plexus - root injury - pathological - classification - MR imaging
