A comparison of MR myelography of brachial plexus injury with CT myelography and conventional myelography.

ABSTRACT

The purpose of study is to assess the accuracy of magnetic resonance myelography (MRM) of the cervical spine in patients with preganglionic Brachial Plexus Injury (BPI) by using CT myelography as the gold standard and comparing this with routine conventional myelography. Patients with a clinically diagnosis of Brachial plexus Injury were studied (9 males, 1 female, aged 16 - 42 years old) [mean age = 25.4 years old]). All patients had undergone clinical evaluation by an orthopedic surgeon and five patients had had additional somatosensory evoked potentials (SEP) performed. All patients were investigated by conventional myelography, computed tomography myelography (CTM) and magnetic resonance myelography (MRM). We used CT myelography as the gold standard and the accuracy of MRM and myelography were assessed in relative to this. The sensitivity in detecting a pseudomeningocele by MRM is 100% and the sensitivity in detecting nerve root abnormality is 90% at the level of the C5, C6 roots and 100% for the C7, C8, T1 roots. MR Myelography had many advantages over conventional and CT myelography which include the absence of radiation and the lack of need for intrathecal injection of contrast medium.