Pacella Giulia, Natella Raffaele, Bruno Federico, Bruno Michela, Franco Donatella, Romano Daniele Giuseppe, Zappia Marcello
Department of Medicine and Health Science "V. Tiberio", University of Molise, 86100 Campobasso, Italy.
Fondazione Trotula de Ruggiero, 84121 Salerno, Italy.
J Clin Med. 2025 Sep 6;14(17):6311. doi: 10.3390/jcm14176311.
Brachial plexopathies comprise a diverse array of illnesses with multifactorial etiologies, including trauma, inflammation, neoplasia, and iatrogenic damage, frequently manifesting with nonspecific clinical symptoms. Precise and prompt imaging evaluation is essential for diagnosis, treatment planning, and monitoring. To equip radiologists with interpretative tools for a systematic assessment of the brachial plexus utilizing advanced imaging modalities, specifically ultrasound (US) and magnetic resonance imaging (MRI), while emphasizing techniques, indications, limitations, and critical radiologic signs for differential diagnosis. This narrative review concentrates on US and MRI. High-frequency linear probes with multiplanar dynamic scans provide US visualization of trunks, cords, and terminal branches in superficial areas. Specialized MRI procedures (T1, T2, STIR, DWI, contrast-enhanced) provide comprehensive evaluation of spinal roots and deep tissues, differentiating preganglionic from postganglionic lesions. A combined US-MRI methodology can enhance diagnostic efficacy. Ultrasound is excellent for superficial and dynamic assessment, especially in post-traumatic and iatrogenic lesions, while MRI is the gold standard for deep structures and complex disorders. The integration of two modalities enhances lesion identification and treatment direction. Emerging methodologies further enhance diagnostic and prognostic capabilities. The synergistic application of US and MRI, emphasizing nerve injury patterns and muscle denervation indicators, facilitates precise and prompt diagnosis of brachial plexopathies. Standardizing imaging standards and incorporating modern techniques are essential for interdisciplinary, customized patient care.
臂丛神经病变包括一系列病因多因素的疾病，包括创伤、炎症、肿瘤和医源性损伤，常表现为非特异性临床症状。精确而及时的影像学评估对于诊断、治疗规划和监测至关重要。为放射科医生提供解读工具，以便利用先进的成像方式，特别是超声（US）和磁共振成像（MRI）对臂丛神经进行系统评估，同时强调鉴别诊断的技术、适应证、局限性和关键放射学征象。本叙述性综述重点关注超声和磁共振成像。具有多平面动态扫描功能的高频线性探头可对浅表区域的神经干、神经束和终末分支进行超声可视化。专门的磁共振成像程序（T1、T2、短T1反转恢复序列、扩散加权成像、增强扫描）可对脊神经根和深部组织进行全面评估，区分节前和节后病变。超声与磁共振成像相结合的方法可提高诊断效能。超声对于浅表和动态评估非常出色，尤其是在创伤后和医源性病变中，而磁共振成像则是深部结构和复杂疾病的金标准。两种模式的结合可提高病变识别能力并指导治疗。新兴方法进一步提高了诊断和预后能力。超声和磁共振成像的协同应用，强调神经损伤模式和肌肉去神经支配指标，有助于精确、及时地诊断臂丛神经病变。标准化成像标准并纳入现代技术对于跨学科、个性化的患者护理至关重要。
