What question did this study set out to answer?

To determine the diagnostic accuracy of preoperative MRI for identifying root avulsions compared with surgical exploration in adults suffering from traumatic brachial plexus injuries.

August 20, 2019RadiologyOpen Access

MRI for Detecting Root Avulsions in Traumatic Adult Brachial Plexus Injuries: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

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Authors

RWRyckie G. WadeLeeds Teaching Hospitals NHS Trust YTYemisi TakwoingiUniversity of Applied Health Sciences JWJustin C.R. WormaldNuffield Orthopaedic Centre

Discussion

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Implication

Systematic review and meta-analysis finds modest diagnostic accuracy for MRI in adult traumatic brachial plexus injury, indicating surgical exploration remains the preferred diagnostic standard.

Key Points

To determine the diagnostic accuracy of preoperative MRI for identifying root avulsions compared with surgical exploration in adults suffering from traumatic brachial plexus injuries.
Searched MEDLINE and Embase through August 20, 2018, for studies evaluating preoperative MRI against surgical exploration in adults with unilateral, nonpenetrating traumatic brachial plexus injuries.
Included 11 studies published between 1992 and 2016 involving 275 adults (mean age, 27 years; 229 men; 84% injured in motorcycle collisions) and conducted bivariate meta-analyses of nerve-root diagnostic accuracy.
Surgical exploration confirmed root avulsions in 72% of patients (IQR: 53%–86%) and across 583 of 918 evaluated nerve roots (median, 55%; IQR: 38%–71%).
Bivariate meta-analysis at the root level demonstrated a mean MRI sensitivity of 93% (95% CI: 77%, 98%) and a mean specificity of 72% (95% CI: 42%, 90%).
All 11 included studies showed risk of bias, with high applicability concerns identified in four studies due to undefined diagnostic criteria, inadequate imaging pulse sequence descriptions, and reader variability.

Cite This Study

Wade et al. (2019) studied this question.

synapsesocial.com/papers/6aa91e344974902b088bdf53 https://doi.org/10.1148/radiol.2019190218

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Implication

Systematic review and meta-analysis finds modest diagnostic accuracy for MRI in adult traumatic brachial plexus injury, indicating surgical exploration remains the preferred diagnostic standard.

MRI for Detecting Root Avulsions in Traumatic Adult Brachial Plexus Injuries: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

Discussion

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Implication

Key Points

Cite This Study

MRI for Detecting Root Avulsions in Traumatic Adult Brachial Plexus Injuries: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

Discussion

Member takes

Implication

Key Points

Cite This Study

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