Imaging the brachial plexus

Imaging the brachial plexus is challenging because of the complex anatomy of the region and the wide variety of pathology that can affect it. For the purpose of imaging, it is helpful to divide traumatic and nontraumatic entities affecting the brachial plexus. Improvements in imaging technology, including multidetector CT for CT myelography and the availability of full-field-strength MRI systems with fast gradients and dedicated surface coils for optimal spatial resolution, have led to more accurate prospective diagnoses and improved aid for neurosurgical planning for traumatic and nontraumatic brachial plexopathies. CT myelography is the current gold standard for the diagnosis of nerve root avulsions affecting the brachial plexus. MRI is the preferred modality for nontraumatic brachial plexopathy. Other modalities, such as US and PET, have a limited role in the evaluation of brachial plexus pathology. High-quality, high-resolution CT and MRI remain the mainstays for imaging the brachial plexus.