Plexopathy Variant 5: Brachial plexopathy, known malignancy or post-treatment syndrome. Initial imaging. This variant encompasses brachial plexopathy occurring in the setting of a known malignancy or a post-treatment syndrome occurring months to years after radiation treatment for a regional malignancy. In addition, patients can develop brachial plexopathy in the months to years after radiation treatment for regional malignancy, which could be due to recurrent tumor or postradiation injury. Imaging can be helpful in differentiating radiation plexopathy from recurrent malignancy [20,79-81], for which management differs significantly. CT Myelography Cervical Spine There is no relevant literature to support the use of CT myelography for evaluation of brachial plexopathy in the setting of known malignancy or post-treatment syndrome. CT myelography provides high-resolution imaging of the thecal sac capable of detecting thecal sac compression or intradural masses; however, it does not directly visualize the postganglionic brachial plexus. CT Cervical Spine There is no relevant literature regarding the use of CT cervical spine in the evaluation of brachial plexopathy in the setting of known malignancy or post-treatment syndrome. CT cervical spine cannot visualize the preganglionic nerve roots and does not fully evaluate the postganglionic brachial plexus because of its narrow field of view and limited soft-tissue contrast resolution relative to MRI. Plexopathy MRI Brachial Plexus Brachial plexus is considered an optimal imaging modality to evaluate brachial plexopathy in the setting of known malignancy or post-treatment syndrome because of its superior soft-tissue contrast and good spatial resolution [6,9,10,27]. Extrinsic compression, direct tumor invasion, or metastasis to the brachial plexus can be demonstrated on MRI brachial plexus. Perineural tumor spread or lymphoma infiltrating the plexus [76] can also be visualized on MRI.
Plexopathy. Plexopathy Variant 5: Brachial plexopathy, known malignancy or post-treatment syndrome. Initial imaging. This variant encompasses brachial plexopathy occurring in the setting of a known malignancy or a post-treatment syndrome occurring months to years after radiation treatment for a regional malignancy. In addition, patients can develop brachial plexopathy in the months to years after radiation treatment for regional malignancy, which could be due to recurrent tumor or postradiation injury. Imaging can be helpful in differentiating radiation plexopathy from recurrent malignancy [20,79-81], for which management differs significantly. CT Myelography Cervical Spine There is no relevant literature to support the use of CT myelography for evaluation of brachial plexopathy in the setting of known malignancy or post-treatment syndrome. CT myelography provides high-resolution imaging of the thecal sac capable of detecting thecal sac compression or intradural masses; however, it does not directly visualize the postganglionic brachial plexus. CT Cervical Spine There is no relevant literature regarding the use of CT cervical spine in the evaluation of brachial plexopathy in the setting of known malignancy or post-treatment syndrome. CT cervical spine cannot visualize the preganglionic nerve roots and does not fully evaluate the postganglionic brachial plexus because of its narrow field of view and limited soft-tissue contrast resolution relative to MRI. Plexopathy MRI Brachial Plexus Brachial plexus is considered an optimal imaging modality to evaluate brachial plexopathy in the setting of known malignancy or post-treatment syndrome because of its superior soft-tissue contrast and good spatial resolution [6,9,10,27]. Extrinsic compression, direct tumor invasion, or metastasis to the brachial plexus can be demonstrated on MRI brachial plexus. Perineural tumor spread or lymphoma infiltrating the plexus [76] can also be visualized on MRI.