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The Application of Ultrasound in the Diagnosis of Brachial Plexus Injury
Xu Jianguang, MD, PhD, Gu Shihui, MD, Xu Lei, Lu Jiuzhou, Wang Yi and Gu Yudong
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
Key Words: Brachial Plexus Injury; Ultrasound; Diagnosis Background: Brachial Plexus Injury (BPI) is a severe disease with high disability rate, a timely and accurate diagnosis is essential for improving the prognosis. Due to the rapid development of ultrasound and MRI in the morphology of brachial plexus and surrounding tissues, ultrasound and MRI have been widely used in the diagnosis and therapy of BPL. Moreover, ultrasound is a noninvasive, inexpensive and widely applicable technology. Aims: Intraoperative exploration was used as a standard for brachial plexus injury to compare the result of ultrasound. Result: Over the past year, 75 Brachial Plexus Injury cases were operated and analyzed. For Brachial Plexus nerve root avulsion, the total ultrasonography coincidence rate was 84%(42/50), including C5 root as 84.6%(11/13)£¬C6 root as 92.3%(12/13)£¬C7 root as 81.8%(9/11)£¬and T1 root as 83.3(5/6). For non avulsion cases, the total coincidence rate of ultrasonography was 97.1%)(34/35), including C5 root as 100%(10/10)£¬C6 root as 87.5%(7/8£©£¬C7 root as 100%(4/4), C8 root as 100%(7/7), and T1 root as 100%(6/6). For neural stem avulation, the total coincidence rate of ultrasonography was 66.7%(2/3), including upper trunk as 100%(1/1); middle trunk as 100%(1/1), and lower trunk as 0%(0/1); for non brachial plexus trunk avulation cases, the total coincidence rate was 100%(17/17), including upper trunk as 100%(9/9)£¬middle trunk as 100%(3/3)and lower trunk as 100%(5/5). For the bundle branches of brachial plexus, the total coincidence rate of ultrasonography was 66.7%(2/3), including the lateral cord as 50%(1/2), medial cord as 100%(1/1), and no post cord was found in last year. For non avulsion cases in cords, the total coincidence rate was 100%(38/38), including lateral cord as 100%(14/14)£¬medial cord as 100%(12/12), and post cord as 100%(12/12)”£ Conclusions: Ultrasound is a promising technology for diagnosis in brachial plexius injury due to its high accuracy of providing effective morphological evidence, noninvasive, dynamic and inexpensive, etc.
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