Abstract Archives of the RSNA, 2004


SSE13-02

Spatial Mapping of the Brachial Plexus Using High Resolution Three-dimensional Ultrasound

Scientific Papers

Presented on November 29, 2004
Presented as part of SSE13: Neuroradiology/Head and Neck (Brachial Plexus and Peripheral Nerves)

Participants

Charlotte J.C. Cash, Presenter: Nothing to Disclose
Anand Sardesai, Abstract Co-Author: Nothing to Disclose
Laurence Berman, Abstract Co-Author: Nothing to Disclose
Martin Herrick, Abstract Co-Author: Nothing to Disclose
Graham Treece PhD, Abstract Co-Author: Nothing to Disclose
Richard Prager PhD, Abstract Co-Author: Nothing to Disclose
Andrew Gee PhD, Abstract Co-Author: Nothing to Disclose
et al, Abstract Co-Author: Nothing to Disclose

PURPOSE

Modern high resolution ultrasound machines are capable of imaging the individual nerves of the brachial plexus. The aim of this study was to map the spatial orientation of the brachial plexus in relation to the carotid and subclavian arteries and the first rib using high resolution 3D ultrasound.

METHOD AND MATERIALS

A freehand optically tracked 3D ultrasound system was used with a 12MHz transducer. Ten healthy volunteers underwent 3D ultrasound of both sides of their neck. From the 3D ultrasound data-sets, the outlines of the brachial plexus, carotid and subclavian artery and the first rib were manually segmented and a surface interpolated.

RESULTS

Eighteen data-sets were recorded. The resolution of the ultrasound data allowed clear depiction of the brachial plexus from its extra-foraminal orgins to its disappearance under the lateral third of the clavicle. The nerves of the plexus were segmented and reconstructed in all 18 cases. Anatomical variations existed that have not been previously described. A deviant course of the C5 nerve root was observed in 2/18 cases. In 6/18 cases, the plexus remained clumped together over the first rib rather than horizontally aligned as was observed in the majority.

CONCLUSIONS

The technique used to reconstruct the brachial plexus illustrated in this study could be used to map plexus injuries and aid the radiotherapist planning supraclavicular radiotherapy to reduce the plexus dose. The anatomical variations observed have implications for selective anaesthesia and explain why ultrasound guided brachial plexus blocks are quicker to perform and achieve more effective pain control.

Cite This Abstract

Cash, C, Sardesai, A, Berman, L, Herrick, M, Treece, G, Prager, R, Gee, A, et al, , Spatial Mapping of the Brachial Plexus Using High Resolution Three-dimensional Ultrasound.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4410897.html