Brakial pleksopatide klinik, EMG ve MR nörografi bulgularının değerlendirilmesi

Yıl 2022, Cilt: 13 Sayı: 47, 243 - 247, 15.12.2022

Sinem Karazincir , Ayşe Dicle Turhanoğlu , Esra Okuyucu , Gülen Burakgazi

https://doi.org/10.17944/mkutfd.971518

Öz

Amaç: Çalışmanın amacı brakial pleksopatide MR nörografi sonuçlarını elektrodiagnostik test ile birlikte değerlendirmek ve MR nörografinin yararlığını saptamaktır.

Yöntem: Brakial pleksopati şüphesi bulunan ve elektrodiagnostik test yapılan 50 hasta çalışmaya dahil edildi. MR nörografide Brakiyal pleksusun kök, gövde ve kord seviyesinde seyri, kalibrasyonu, sinyal yoğunluğu ve devamlılığı 2 bağımsız radyolog tarafından değerlendirildi.

Bulgular: Elektrodiagnostik test altın standart tanı testi kabul edilerek yapılan analizde MR nörografinin tanısal doğruluk, duyarlılık, özgüllüğü; 1. okuyucu için sırasıyla %64, %45.16, %94.73; 2. okuyucu için sırasıyla %74, %67.74, %84.21 idi. Okuyucular arası tutarlılık %78 idi.

Sonuç: Brakial pleksopati klinik şüphesi bulunan hastalarda MR’ın duyarlılığı ve okuyucular arasındaki uyum orta derecede bulundu. MR nörografi brakial pleksopatiyi gösterebilir ancak pleksusun normal görünümü pleksopati tanısını dışlamamalıdır.

Anahtar Kelimeler

brakial pleksus, pleksopati, MR nörografi, elektrodiagnostik test

Destekleyen Kurum

Hatay Mustafa Kemal Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi

Proje Numarası

16794

Evaluation of clinical, EMG and MR neurography findings in brachial plexopathy

Öz

Objective: The aim of our study was to correlate the results of MR neurography with electrodiagnostic testing in order to determine the usefulness of MR neurography.

Method: 50 patients with suspected plexopathy who underwent electrodiagnostic test were included in the study. In MR neurography, the course, calibration, signal intensity and continuity of the brachial plexus at the root, trunk and cord level were evaluated by 2 independent radiologists.

Results: The diagnostic accuracy, sensitivity and specificity of MR neurography in the analysis performed by using the electrodiagnostic test gold standard diagnostic test; for the 1st reader, 64%, 45.16%, 94.73%, respectively; for the 2nd reader, 74%, 67.74%, 84.21%, respectively. Inter-reader consistency was to be 78%.

Conclusion: In patients with clinical suspicion of brachial plexopathy, the sensitivity of MR and the agreement between readers was found to be moderate. MR neurography of the brachial plexus may show brachial plexopathy, but normal MR neurography appearance of the plexus should not exclude the diagnosis of plexopathy.

Anahtar Kelimeler

brachial plexus, plexopathy, MR neurography, electrodiagnostic test

Proje Numarası

16794

Kaynakça

• Johnson EO, Vekris M, Demesticha T, Soucacos PN. Neuroanatomy of the brachial plexus: normal and variant anatomy of its formation. Surg Radiol Anat 2010;32:291-7. https://doi.org/10.1007/s00276-010-0646-0
• van Es HW, Bollen TL, van Heesewijk HP. MRI of the brachial plexus: a pictorial review. European journal of radiology. 2010;74(2):391-402. https://doi.org/10.1016/j.ejrad.2009.05.067
• Tharin BD, Kini JA, York GE, Ritter JL. Brachial plexopathy: a review of traumatic and nontraumatic causes. AJR American journal of roentgenology. 2014;202(1):W67-75. https://doi.org/10.2214/AJR.12.9554
• Fan YL, Othman MI, Dubey N, Peh WC. Magnetic resonance imaging of traumatic and non-traumatic brachial plexopathies Singapore Med J. 2016 Oct;57(10):552-560. https://doi.org/10.11622/smedj.2016166
• Fisher S, Wadhwa V, Manthuruthil C, Cheng J, Chhabra A. Clinical impact of magnetic resonance neurography in patients with brachial plexus neuropathies. The British journal of radiology. 2016;89(1067):20160503. Epub 2016 Sep 19. https://doi.org/10.1259/bjr.20160503
• Chhabra, G.K. Thawait, T. Soldatos, R.S. Thakkar, F. Del Grande, M. Chalian et al. High-Resolution 3T MR Neurography of the Brachial Plexus and Its Branches, with Emphasis on 3D Imaging. AJNR Am J Neuroradio March 2013, 34 (3) 486-497. https://doi.org/10.3174/ajnr.A3287
• Kang S, Yoon JS, Hong SJ, Yang SN. Degree of Agreement between Electrodiagnostic Testing and Magnetic Resonance Imaging in the Evaluation of Brachial Plexopathy. American journal of physical medicine & rehabilitation 2019. 98(7):545-548. https://doi.org/10.1097/PHM.0000000000001139
• Nardin RA, Patel MR, Gudas TF, Rutkove SB, Raynor EM. Electromyography and magnetic resonance imaging in the evaluation of radiculopathy. Muscle & nerve 1999; 22(2):151-5. https://doi.org/10.1002/(sici)1097-4598(199902)22:2<151::aid-mus2>3.0.co;2-b
• Ferrante MA: Electrodiagnostic assessment of the brachial plexus. Neurol Clin 2012. May;30(2):551-80. Epub 2011 Dec 30. https://doi.org/10.1016/j.ncl.2011.12.005.
• Torres C, Mailley K, Del Carpio O’Donovan R. MRI of the brachial plexus: modified imaging technique leading to a better characterization of its anatomy and pathology. The neuroradiology journal. 2013;26(6):699-719. Epub 2013 Dec 18. https://doi.org/10.1177/197140091302600614
• Lutz AM, Gold G, Beaulieu C. MR imaging of the brachial plexus. Neuroimaging clinics of North America. 2014;24(1):91-108. Epub 2013 May 16. https://doi.org/10.1016/j.nic.2013.03.024
• Chhabra A, Andreisek G, Soldatos T, Wang KC, Flammang AJ, Belzberg AJ, et al. MR Neurography: Past, Present, and Future. American Journal of Roentgenology. 2011;197(3):583-91. https://doi.org/10.2214/AJR.10.6012
• Upadhyaya V, Upadhyaya D. Current status of magnetic resonance neurography in evaluating patients with btachial plexopathy. Neurol İndia 2019;67:S118-S124. https://doi.org/10.4103/0028-3886.250730
• Bilbey JH, Lamond RG, Mattrey RF. MR imaging of disorders of the brachial plexus. J Magn Reson Imaging 1994;4:13-8 https://doi.org/10.1002/jmri.1880040106
• Zhang L, Xiao T, Yu Q, Li Y, Shen F, Li W. Clinical Value and Diagnostic Accuracy of 3.0T Multi-Parameter Magnetic Resonance Imaging in Traumatic Brachial Plexus Injury. Med Sci Monit. 2018;24:7199-7205. https://doi.org/10.12659/MSM.907019
• Upadhyaya V, Upadhyaya DN, Kumar A, Gujral RB. MR neurography in traumatic brachial plexopathy. European journal of radiology 2015. May;84(5):927-32. Epub 2015 Feb 16. https://doi.org/10.1016/j.ejrad.2015.02.006
• Crim J, Ingalls K. Accuracy of MR neurography in the diagnosis of brachial plexopathy. European journal of radiology 2017;95:24-27. https://doi.org/10.1016/j.ejrad.2017.07.012. Epub 2017 Jul 19
• Chabra, 18. Tagliafico A, Succio G, Emanuele Neumaier C, Serafini G, Ghidara M, Calabrese M, 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):717-24. https://doi.org/10.1007/s00256-010-1050-x. Epub 2010 Oct 23