0:00

So here's a patient that presents,

0:02

uh, with left-sided brachial neuritis.

0:05

And the reason that we show this

0:07

case is to emphasize the importance

0:09

of obtaining some type of sequence.

0:12

that optimizes the nerve sheath.

0:17

Some people will call this MR neurography.

0:19

I tend not to use that term.

0:21

I just tend to use the sequence, such as an STIR

0:24

sequence or a heavily T2-weighted sequence.

0:26

But you can hear the term MR

0:28

neurography used as well, too.

0:31

So, this is an example on the left-hand side

0:33

of a fat-suppressed T1-weighted image where

0:35

we're looking for the brachial plexus, so we

0:37

know the patient has right-sided symptoms.

0:40

So, again, the way that I approach this

0:41

is I look for the subclavian artery,

0:44

which is located right here, and then

0:46

right above it is the brachial plexus.

0:48

So, as I scroll back and forth, you can

0:51

see the cords of the brachial plexus laying

0:53

right on top of the subclavian artery.

0:55

And then when we compare the left

0:57

side to the right side, again, we

0:59

can find the subclavian artery here.

1:01

We can see the cords of the brachial

1:03

plexus, and they look really symmetric.

1:05

So again, there's no compressive masses.

1:08

It doesn't really seem to be

1:09

anything that's largely wrong, if

1:12

you will, with the brachial plexus.

1:14

But when we look at the STIR weighted

1:17

sequences, what we see here is asymmetrically

1:20

increased signal involving the cords

1:22

of the brachial plexus on the left.

1:24

Compared to the right.

1:26

So, here's the abnormal signal on the left.

1:29

On the right-hand side,

1:30

there's our subclavian artery.

1:32

So we know that the cords of the brachial plexus

1:35

are going to be just adjacent to it, but we

1:38

can see that when we compare the left to the

1:40

right, we can see that there's abnormal signal.

1:43

So again, this is an inflammation

1:44

involving the left brachial plexus.

1:47

This represents a neuritis, and on this

1:49

collapsed image here, we can see the

1:51

abnormal signal right here involving the

1:54

brachial plexus as demarcated by the green

1:56

arrow compared to the right-hand side.

1:59

So, in summary, this is an example of a

2:02

left-sided brachial neuritis, and it's

2:05

best evaluated with a heavily T2-weighted

2:08

image with fat suppression or a STIR

2:11

sequence, or any type of sequences that

2:13

optimize visualization of the nerve.