The role of MRI in assessing tumors involving the brachial plexus is to ¹:

• assess whether nerves are displaced, compressed or infiltrated
• decide whether mass is intrinsic or extrinsic to brachial plexus
• aid in pre-op planning

Tumors can be divided into primary tumors and secondary metastases. They appear as focal or multifocal thickening of a section of the brachial plexus and are usually low intensity on T1-weighted imaging and high intensity on T2-weighted imaging. They typically enhance with contrast. Other evidence of neoplastic disease affecting the brachial plexus includes lymphadenopathy, bony lesions, intrathoracic and chest wall masses. Presence or absence of a tumor may be difficult to ascertain with MRI alone, and a high index of suspicion needs to be applied especially if symptoms such as pain or neurological deficits are present. Further follow-up with repeat MRI, FDG-PET scan or core biopsy may be required ^2,3.

Case courtesy of A/Prof Pramit Phal.