MR neurography in Parsonage-Turner syndrome

Indian Journal of Radiology and Imaging - Tập 29 Số 03 - Trang 264-270 - 2019
Vaishali Upadhyaya1, Divya Narain Upadhyaya1, Richa Bansal2, Tarun Pandey3, Ashok Kumar Pandey4
1Departments of Radiology, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Nirala Nagar
2Department of Radiology, Max Superspecialty Hospital, Saket, New Delhi, India
3Departments of Neurosurgery, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Nirala Nagar
4Departments of Neurology, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Nirala Nagar

Tóm tắt

AbstractBackground and Aims: Parsonage Turner Syndrome is a well known clinical entity. Several excellent articles have succinctly described Magnetic Resonance Imaging (MRI) findings in PTS. However, these articles have inferred neural involvement in PTS based on the patterns of denervation of muscles in the shoulder region. The aim of this study is to directly visualize the distribution and extent of abnormality in MR Neurography (MRN) of the brachial plexus in known cases of brachial plexus neuritis or Parsonage-Turner Syndrome (PTS). Methods: 15 patients who were diagnosed with PTS based on clinical and electrophysiological findings participated in the study. MRN of the brachial plexus was done in a 1.5T system using a combination of T1W (T1-weighted), T2W (T2-weighted) fat-saturated, STIR (Short Tau Inversion Recovery), 3D STIR SPACE (Sampling Perfection with Application Optimized Contrasts) and 3D T2W SPACE sequences. Findings were recorded and assessed. Results: The age range of our patients was 7-65 years (mean 37.87 years). Most of the patients had unilateral symptoms. All patients had weakness in shoulder abduction. Other common associated complaints included pain in the shoulder/neck/arm and preceding fever. MRN revealed the percentage of involvement of roots, trunks, cords and terminal branches was 53.3%, 46.7%, 40% and 13.3% respectively. Evidence of muscle denervation in the form of edema, fatty infiltration and atrophy was noted in 8 (53.3%) patients. Conclusion: Most of the patients in this study had unilateral involvement on MRN. The roots were the commonest site of involvement followed by the trunks, cords and terminal branches. C5 was the most commonly involved root.

Từ khóa


Tài liệu tham khảo

J D Spillane, 1943, Localised neuritis of the shoulder girdle. A report of 46 cases in the MEF, Lancet, 242, 532, 10.1016/S0140-6736(00)72665-1

M J Parsonage, 1948, Neuralgic amyotrophy. The shoulder-girdle syndrome, Lancet, 251, 973, 10.1016/S0140-6736(48)90611-4

R E Scalf, 2007, MRI findings of 26 patients with parsonage-turner syndrome, AJR, 189, W39, 10.2214/AJR.06.1136

C M Gaskin, 2006, Parsonage-turner syndrome: MR imaging findings and clinical information of 27 patients, Radiology, 240, 501, 10.1148/radiol.2402050405

M Luigetti, 2013, MRI neurography findings in patients with idiopathic brachial plexopathy: Correlations with clinical-neurophysiological data in eight consecutive cases, Intern Med, 52, 2031, 10.2169/internalmedicine.52.0533

G A Grant, 2004, MR neurography: Diagnostic utility in the surgical treatment of peripheral nerve disorders, Neuroimag Clin N Am, 14, 115, 10.1016/j.nic.2004.02.003

A Filler, 2009, MR neurography and diffusion tensor imaging: Origins, history and clinical impact of the first 50,000 cases with an assessment of efficacy and utility in a prospective 5,000 patient study group, Neurosurgery, 65, A29, 10.1227/01.NEU.0000351279.78110.00

A G Filler, 1996, Application of magnetic resonance neurography in the evaluation of patients with peripheral nerve pathology, J Neurosurg, 85, 299, 10.3171/jns.1996.85.2.0299

A Chhabra, 2011, MR neurography: Past, present, and future, AJR Am J Roentgenol, 197, 583, 10.2214/AJR.10.6012

B C Bowen, 2004, The brachial plexus: Normal anatomy, pathology, and MR imaging, Neuroimag Clin N Am, 14, 59, 10.1016/j.nic.2003.12.002

A Mallouhi, 2012, 3T MR tomography of the brachial plexus: Structural and microstructural evaluation, Eur J Radiol, 81, 2231, 10.1016/j.ejrad.2011.05.021

A Chhabra, 2013, High-resolution 3T MR neurography of the brachial plexus and its branches, with emphasis on 3D imaging, AJNR Am J Neuroradiol, 34, 486, 10.3174/ajnr.A3287

A Lutz, 2014, MR Imaging of the brachial plexus, Neuroimag Clin N Am, 24, 91, 10.1016/j.nic.2013.03.024

V Upadhyaya, 2015, MR neurography in traumatic brachial plexopathy, Eur J Radiol, 84, 927, 10.1016/j.ejrad.2015.02.006

V Upadhyaya, 2015, Magnetic resonance neurography of the brachial plexus, Indian J Plast Surg, 48, 129, 10.4103/0970-0358.163045

T M Noguerol, 2017, Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries, Quant Imaging Med Surg, 7, 398, 10.21037/qims.2017.08.01

J Crim, 2017, Accuracy of MR neurography in the diagnosis of brachial plexopathy, Eur J Radiol, 95, 24, 10.1016/j.ejrad.2017.07.012

N Van Alfen, 2006, The clinical spectrum of neuralgic amyotrophy in 246 cases, Brain, 129, 438, 10.1093/brain/awh722

J J Van Eijk, 2016, Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment, Muscle Nerve, 53, 337, 10.1002/mus.25008

N Van Alfen, 2011, Clinical and pathophysiological concepts of neuralgic amyotrophy, Nat Rev Neurol, 7, 315, 10.1038/nrneurol.2011.62

D Lieba-Samal, 2016, Neuroimaging of classic neuralgic amyotrophy, Muscle Nerve, 54, 1079, 10.1002/mus.25147

I Duman, 2007, Neuralgic amyotrophy, diagnosed with magnetic resonance neurography in acute stage. A case report and review of the literature, Neurologist, 13, 219, 10.1097/NRL.0b013e31805778bb

S Sarikaya, 2005, Magnetic resonance neurography diagnosed brachial plexitis: A case report, Arch Phys Med Rehabil, 86, 1058, 10.1016/j.apmr.2004.08.003

M Ryan, 2004, Whole body magnetic resonance imaging in the diagnosis of parsonage turner syndrome, Acta Radiol, 5, 534, 10.1080/02841850410006083

B N Delman, 2011, Imaging of the brachial plexus, 5th ed, 2743

D-K Yu, 2010, Neuroradiologic and neurophysiologic findings of neuralgic amyotrophy, J Korean Neurosurg Soc, 48, 423, 10.3340/jkns.2010.48.5.423

C Wessig, 2004, Muscle magnetic resonance imaging of denervation and reinnervation: Correlation with electrophysiology and histology, Exp Neurol, 185, 254, 10.1016/j.expneurol.2003.10.012

S Yanny, 2010, MR patterns of denervation around the shoulder, AJR Am J Roentgenol, 195, W157, 10.2214/AJR.09.4127

C A Helms, 1998, Acute brachial neuritis (Parsonage-turner syndrome): MR imaging appearance- report of three cases, Radiology, 207, 255, 10.1148/radiology.207.1.9530324

Thông tin
Thông tin xuất bản

Indian Journal of Radiology and Imaging

Tập 29 Số 03

264-270

Thông tin tác giả