A prospective study of high resolution ultrasound in brachial plexopathies - Correlation with electrophysiological measurements

Clin Neurophysiol. 2019 Jul;130(7):1144-1150. doi: 10.1016/j.clinph.2019.03.034. Epub 2019 Apr 30.

Abstract

Objectives: To evaluate the diagnostic role of ultrasound in brachial plexopathies.

Methods: We included 59 healthy subjects (HS) and 42 patients consecutively referred with clinical suspicion of brachial plexopathy from October 2015 to May 2016. Patients underwent routine electrodiagnostic testing (EDx) as reference standard and a blinded standardised ultrasound examination of the brachial plexus as index test with cross-sectional area (CSA) as the ultrasound parameter of choice.

Results: Seventeen patients were diagnosed by EDx with brachial plexopathy, ten with mononeuropathies, and ten had normal EDx. Five had a cervical radiculopathy. In 11 (64%) out of the 17 patients with EDx diagnosed plexopathy, we found at least one abnormal level on ultrasound. Six (60%) out of ten normal EDx patients had a normal ultrasound examination at all levels. Ultrasound identified the same abnormal level(s) as EDx in eight (73%) of the 11 patients who had both abnormal EDx and ultrasound results. Mean CSA was higher in the plexopathy group compared to HS at the level of the C6 root (p = .022), the middle trunk (p = .027), and the medial cord (p = .003).

Conclusion: Ultrasound examination showed abnormalities in patients with brachial plexopathies in good agreement with EDx.

Significance: Ultrasound may be an important supplement to electrodiagnostics in evaluating brachial plexopathies.

Keywords: Brachial plexopathy; Brachial plexus; Diagnostics; Nerve conduction study; Ultrasound.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brachial Plexus / diagnostic imaging*
  • Brachial Plexus Neuropathies / diagnostic imaging*
  • Electrodiagnosis / standards
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Positioning / methods
  • Prospective Studies
  • Reference Standards
  • Regression Analysis
  • Reproducibility of Results
  • Single-Blind Method
  • Ultrasonography / methods*