E2201. Prevalence of Incidental Findings and Their Characterization on Brachial Plexus MRI
  1. Dawood Tafti; Brooke Army Medical Center
  2. Ilsup Yoon; Brooke Army Medical Center
  3. Timothy Russell; Martin Army Community Hospital
  4. Nathan Cecava; Brooke Army Medical Center
  5. Douglas Byerly; Brooke Army Medical Center
  6. Francis Cloran; Brooke Army Medical Center
Brachial Plexus MRI is the imaging modality of choice for evaluation of the anatomy and pathology of the brachial plexus. As the field-of-view of brachial plexus MRI often includes the glenohumeral joint and the upper thorax, these studies can reveal non-neural findings of clinical significance.

Materials and Methods:
Brachial plexus MRIs from 99 patients between 1999 to 2019 with comparison shoulder MRIs within the last 6 months were included in the study. Images were retrospectively reviewed for findings outside of the brachial plexus network of nerves.

Non-neural incidental findings were found in 81/110 (73%) of reviewed studies. In total, 215 incidental findings were noted. 25 out of 110 patients (23%) were noted to have significant clinical findings, while 24 out of 110 patients (22%) were considered of intermediate clinical significance. The remaining 31 out of 110 patients had findings of mild clinical significance (29%), while 22 out of 110 patients had no notable findings (20%). Significant clinical findings included muscle edema, muscle tear, bone edema, and fractures. Moderately significant findings included labral tear and RTC tendon tears. The coronal T2 STIR and axial T2 STIR sequences were most sensitive in the detection of abnormalities.

In total, 73% of our patients had non-neural findings with a vast majority representing musculoskeletal pathology. Pathology of the brachial plexus was infrequent on imaging and was noted in % of our patients. High prevalence of musculoskeletal findings on brachial plexus MRI suggests a role of dedicated field-of-view sequences of the shoulder girdle.