Pearlene P. Lee BA, Presenter: Nothing to Disclose

Kenneth Chung-Yi Wang MD, PhD, Abstract Co-Author: Nothing to Disclose

Avneesh Chhabra MD, Abstract Co-Author: Research grant, Siemens AG Research Consultant, Siemens AG Research grant, Integra LifeSciences Holdings Corporation Research grant, General Electric Company

Eliot L. Siegel MD, Abstract Co-Author: Research grant, General Electric Company Speakers Bureau, Siemens AG Board of Directors, Carestream Health, Inc Research grant, XYBIX Systems, Inc Research grant, Steelcase, Inc Research grant, Anthro Corp Research grant, RedRick Technologies Inc Research grant, Evolved Technologies Corporation Research grant, Barco nv Research grant, Intel Corporation Research grant, Dell Inc Research grant, Herman Miller, Inc Research grant, Virtual Radiology Research grant, Anatomical Travelogue, Inc Medical Advisory Board, Fovia, Inc Medical Advisory Board, Vital Images Medical Advisory Board, McKesson Corporation Medical Advisory Board, Carestream Health, Inc Medical Advisory Board, Bayer AG Research, TeraRecon, Inc Medical Advisory Board, Bracco Group Researcher, Bracco Group Medical Advisory Board, Merge Healthcare Incorporated Medical Advisory Board, Microsoft Corporation Researcher, Microsoft Corporation

John A. Carrino MD, MPH, Abstract Co-Author: Research grant, Siemens AG Research grant, Carestream Health, Inc Research Consultant, General Electric Company

This exhibit will demonstrate the application of the AIM and RadLex standards to the annotation of brachial plexus MRI, enabling ontology-assisted navigation of image-based reference material. This approach may also be useful in other difficult-diagnosis situations.  

The brachial plexus can be a challenging area in diagnostic imaging due to complex anatomic, physiologic and pathologic relationships in this region. While high field strength MRI can provide increasingly detailed imaging of the brachial plexus, interpretation often depends on familiarity not only with nerve structure, but also an in-depth understanding of anatomic spaces, nerve-muscle innervation patterns, and variant anatomy which can predispose to impingement. Here we describe standards-based annotation of 3T MR images to enable dynamic reference resources in this difficult-diagnosis area.

Following retrospective review of our image archive, high-resolution 3T reference cases of brachial plexus anatomy and disease were selected. Using the AIM standard for image annotation and mark-up, and the RadLex ontology of radiologic terms and concepts, we then created an imaging database of the brachial plexus incorporating nerve segments, anatomic spaces, neuromuscular relationships, regional muscular, bony and vascular anatomy, as well as a range of common brachial plexus pathologies.

Our database consists of multiplanar 3T MR images and AIM-compliant XML-based annotations, depicting neural elements of the brachial plexus, the scalene triangle, costoclavicular space and retropectoralis minor space, as well as relevant musculature of the upper extremity which may be affected by brachial plexopathies. The image annotations also include a range of anatomic variants and specific pathologies such as cervical ribs, peripheral nerve sheath tumors, post-traumatic injury, and metastatic disease involving the brachial plexus. Through standardized terms and data representations, the database is designed to facilitate machine parsing of image content and ontology-assisted navigation of the various aspects of brachial plexus MRI.  

Lee, P, Wang, K, Chhabra, A, Siegel, E, Carrino, J, AIM and RadLex for Musculoskeletal Diagnostic Decision Support: Navigating 3 T MR Anatomy and Disease of the Brachial Plexus.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11013412.html