The diagnostic utility of magnetic resonance neurography in diagnosis of plexus and peripheral neuropathies compared to electroneurophysiological studies

Background Magnetic resonance neurography (MRN) has emerged as a powerful imaging modality for evaluating peripheral and plexus neuropathies, offering significant advantages over traditional electrodiagnostic studies such as electromyography (EMG) and nerve conduction studies (NCS). Purpose This study aimed to assess the diagnostic utility of MRN in comparison to these conventional methods, evaluating its strengths, limitations, and clinical applications in neuropathy assessment. Methods A cross-sectional study was conducted on 33 patients presenting with radiculopathy or plexopathy. All participants underwent comprehensive clinical evaluation, EMG, NCS, and MRN. Statistical analysis was performed using SPSS v26, incorporating correlation studies, diagnostic sensitivity, specificity, and predictive values of each modality, receiver operating characteristic curve analysis, and comparative evaluations. Results Magnetic resonance neurography showed high sensitivity (90%) and specificity (43.48%) in predicting EMG abnormalities, with an area under the curve of 0.774. MRN showed 100% sensitivity and specificity in predicting NCS abnormalities. There was a moderately strong and statistically significant positive correlation between EMG and MRN studies ( r = 0.616, p = 0.004*), while there was a weak correlation between EMG and NCS studies that was not statistically significant ( r = 0.066, p = 0.733). Conclusions These findings highlight MRN’s ability to provide detailed anatomical visualization of nerve pathology, particularly in cases where EMG and NCS yield inconclusive results. Moreover, MRN is instrumental in detecting early structural changes, aiding in preoperative planning, and improving diagnostic confidence in complex neuropathies.