MR imaging in clinically suspected brachial plexus tumor

Abstract

We performed MR studies on 47 patients who were suspected of having brachial plexus involvement with tumor. Twenty-two of these patients had signs and symptoms suggesting brachial plexus tumor; 25 had known tumors that were juxtaposed to the brachial plexus but that could easily extend into the brachial plexus. These patients had no signs or symptoms. Using a 1.5-T clinical imaging system, we obtained single echo (T1- and T2-weighted) or double-echo (intermediate-weighted and T2-weighted) images in the coronal plane and supplemented these by images in the axial or sagittal planes. MR imaging encompassed the entire brachial plexus including roots, trunks, and cords. The imager body coil and a variety of surface coils were used for signal reception. MR findings were confirmed by surgery (n = 12) or response to radiation therapy on follow-up imaging (n = 3) in cases in which there was tumor involving the brachial plexus and by surgery (n = 9) or follow-up (n = 23) in cases in which there was no brachial plexus tumor. MR correctly identified all 15 cases of tumor involving the brachial plexus in patients with suggestive signs and symptoms; MR also correctly showed no tumor involvement in seven patients who had suggestive signs and symptoms. In 25 patients with no neurologic signs or symptoms, MR correctly identified tumor outside the brachial plexus that did not involve the brachial plexus. This study indicates that MR may have substantial clinical utility in evaluating patients for suspected brachial plexus tumor, particularly in patients with suggestive neurologic signs and symptoms.