Diagnostic Accuracy of the Magnetic Resonance Imaging in Adult Post-Ganglionic Brachial Plexus Traumatic Injuries: A Systematic Review and Meta-Analysis.

BACKGROUND

Traumatic brachial plexus injuries are rare but serious consequences of major traumas. Pre-ganglionic lesions are considered irreparable, while post-ganglionic injuries can be potentially treated if an early diagnosis is available. Pre-surgical diagnosis is important to distinguish low-grade from high-grade lesions and to identify their location. The aim of the review is to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in the identification of adult post-ganglionic lesions due to traumatic brachial plexus injuries, compared to intraoperative findings.

METHODS

Research on the main scientific electronic databases was conducted. Studies of adults with traumatic post-ganglionic brachial plexus injuries were included. The index test was preoperative MRI and the reference standard was surgical exploration. Pooled sensitivity and specificity were calculated.

RESULTS

Four studies were included for the systematic review, of which three articles met the inclusion criteria for the meta-analysis. Pooled sensitivity and pooled specificity values resulted high. The sensitivity value is associated with a high heterogeneity index of the selected literature.

CONCLUSION

MRI can be considered, despite the limits, the gold standard exam in morphological evaluation of brachial plexus injuries, particularly in the diagnosis of post-ganglionic traumatic injuries.