AUTHOR=Wade Ryckie G. , Tanner Steven F. , Teh Irvin , Ridgway John P. , Shelley David , Chaka Brian , Rankine James J. , Andersson Gustav , Wiberg Mikael , Bourke Grainne TITLE=Diffusion Tensor Imaging for Diagnosing Root Avulsions in Traumatic Adult Brachial Plexus Injuries: A Proof-of-Concept Study JOURNAL=Frontiers in Surgery VOLUME=7 YEAR=2020 URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2020.00019 DOI=10.3389/fsurg.2020.00019 ISSN=2296-875X ABSTRACT=
Cross-sectional MRI has modest diagnostic accuracy for diagnosing traumatic brachial plexus root avulsions. Consequently, patients either undergo major exploratory surgery or months of surveillance to determine if and what nerve reconstruction is needed. This study aimed to develop a diffusion tensor imaging (DTI) protocol at 3 Tesla to visualize normal roots and identify traumatic root avulsions of the brachial plexus. Seven healthy adults and 12 adults with known (operatively explored) unilateral traumatic brachial plexus root avulsions were scanned. DTI was acquired using a single-shot echo-planar imaging sequence at 3 Tesla. The brachial plexus was visualized by deterministic tractography. Fractional anisotropy (FA) and mean diffusivity (MD) were calculated for injured and avulsed roots in the lateral recesses of the vertebral foramen. Compared to healthy nerves roots, the FA of avulsed nerve roots was lower (mean difference 0.1 [95% CI 0.07, 0.13];