MR imaging sequences obtained in brachial plexopathy with/without TOS
| MR Imaging Sequences | Associated Anatomic Structures or Pathologic Conditions |
|---|---|
| Sagittal TSE T2WI through cervical spine | Spinal cord lesion (edema, hemorrhage, avulsion, myelomalacia, syrinx, tumor, etc) |
| Precontrast axiala T1WI | BPL (thickening, nodularity) |
| Precontrast coronalb T1WI | BPL, vertebrae, long C7 transverse process, cervical rib |
| Axiala 2D TSE T2WI | BPL (thickening, nodularity, signal changes better seen between anterior and middle scalene muscles), radiculopathy, diskopathy, foraminal invasion, spinal cord lesions, large-sized pseudomeningocele, muscle denervation |
| Coronalb STIR T2WI | BPL (any signal changes not detectable on 2D TSE T2WI, especially in traction injuries and brachial plexitis), muscle denervation in traumatic injury, and brachial plexitis |
| Axiala 3D TSE heavily T2WI (MR myelography) | Root avulsions, small-sized pseudomeningocele, which can be missed on 2D TSE T2WI. |
| Postcontrast fat-saturated axiala T1WI | BPL (contrast enhancement), contrast enhancement of root stump or intradural roots or denervated muscles in preganglionic injuries |
| Postcontrast coronalb T1WI | BPL (contrast enhancement) |
| Sagittalc,d T1WI from the symptomatic side in abduction | Compression on BPL and subclavian vessels (positional, cervical rib, long C7 transverse process, accessory muscles, fibrous band) |
| Sagittalc,d T1WI from the symptomatic side in neutral if there is compression | Resolution of compression on the BPL and subclavian vessels |
| MRAc and MRVc of subclavian artery and vein in abduction | Subclavian artery and vein (patency, thrombosis, aneurysm, any impingement on the vessels) |
| MRAc and MRVc of subclavian artery and vein next day in neutral if there is impingement | Resolution of impingement on the subclavian vessels |
a Perpendicular to the long axis of the vertebrae in the coronal plane.
b Parallel to the long axis of the lower cervical vertebrae of C4-C7.
c Additional MR imaging sequences obtained when there is clinical suspicion of TOS.
d Perpendicular to the long axis of the BPL from the spinal cord to the medial border of the humerus.