Imaging of neuralgic amyotrophy in the acute phase

Introduction/Aims Hourglass‐like constrictions (HGCs) occur in neuralgic amyotrophy (NA), but the earliest time at which they can be recognized by imaging is poorly understood. We aimed to determine the prevalence of abnormal imaging findings in the acute phase of NA. Methods Magnetic resonance neur...

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Bibliographic Details
Published in:Muscle & nerve Vol. 66; no. 6; pp. 709 - 714
Main Authors: Ripellino, Paolo, Arányi, Zsuzsanna, Alfen, Nens, Ventura, Elisa, Peyer, Anne‐Kathrin, Cianfoni, Alessandro, Gobbi, Claudio, Pedrick, Emily, Sneag, Darryl Brett
Format: Journal Article
Language:English
Published: Hoboken, USA John Wiley & Sons, Inc 01.12.2022
Wiley Subscription Services, Inc
Subjects:
Abnormalities
brachial plexus
Brachial Plexus Neuritis - diagnostic imaging
Denervation
Edema
Electromyography
Fibrillation
Humans
Magnetic resonance
Magnetic Resonance Imaging - methods
Medical imaging
MR neurography
Muscles
Nerve Tissue
Nerves
neuralgic amyotrophy
neuromuscular ultrasound
Parsonage‐Turner syndrome
Ultrasonography
brachial plexus
neuromuscular ultrasound
Parsonage-Turner syndrome
neuralgic amyotrophy
MR neurography
ISSN:0148-639X, 1097-4598, 1097-4598
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Summary:Introduction/Aims Hourglass‐like constrictions (HGCs) occur in neuralgic amyotrophy (NA), but the earliest time at which they can be recognized by imaging is poorly understood. We aimed to determine the prevalence of abnormal imaging findings in the acute phase of NA. Methods Magnetic resonance neurography (MRN) and high‐resolution ultrasound (US) examinations were performed at five sites. The investigation included 39 patients with acute NA who underwent imaging within 31 days of symptom onset. Correlation between imaging and electromyography (EMG) findings was measured. Results US was performed in 29 patients and MRN in 23; 16 patients underwent US only, 10 MRN only, and 13 had both. US and MRN showed nerve abnormalities within 1 mo from NA onset in 90% of patients. HGCs were found in 74% (29/39) of the patients: 4 within 1 wk, 8 within 2 wk, 5 within 3 wk, and 12 within 4 wk. The earliest HGC on US was found within 12 h, and on MRN within 3 days from symptom onset. MRN demonstrated a denervation edema pattern of affected muscles in 91% of the patients. The shortest time to observe an edema pattern on MRN was 8 days. EMG was performed in 30 patients and revealed fibrillation potentials in affected muscles in 22 (73%). A denervation edema pattern on MRN was significantly associated with the presence of HGCs both on MRN and US, and with fibrillation potentials on EMG. Discussion In the early phase of NA, US and MRN are useful diagnostic techniques for demonstrating nerve abnormalities.
Bibliography:Funding information
Advisory Board of scientific Research Ente Ospedaliero Cantonale, Grant/Award Number: ABREOC 2018; Baasch‐Medicus Stiftung, Grant/Award Number: research fellowship 2018 to Paolo Ripellino; National Institute of Health (NIH), Grant/Award Number: National Center for Advancing Translational Scienc
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ISSN:0148-639X
1097-4598
1097-4598
DOI:10.1002/mus.27732