Diffusion tensor imaging of the roots of the brachial plexus: a systematic review and meta-analysis of normative values
- PDF / 5,090,790 Bytes
- 13 Pages / 595.276 x 790.866 pts Page_size
- 22 Downloads / 153 Views
META-ANALYSIS
Diffusion tensor imaging of the roots of the brachial plexus: a systematic review and meta‑analysis of normative values Ryckie G. Wade1,2 · Alexander Whittam3 · Irvin Teh4 · Gustav Andersson5,6,8 · Fang‑Cheng Yeh7 · Mikael Wiberg5,6 · Grainne Bourke1,2,5,6 Received: 19 May 2020 / Accepted: 25 September 2020 © The Author(s) 2020
Abstract Purpose Diffusion tensor magnetic resonance imaging (DTI) characterises tissue microstructure and provides proxy measures of myelination, axon diameter, fibre density and organisation. This may be valuable in the assessment of the roots of the brachial plexus in health and disease. Therefore, there is a need to define the normal DTI values. Methods The literature was systematically searched for studies of asymptomatic adults who underwent DTI of the brachial plexus. Participant characteristics, scanning protocols, and measurements of the fractional anisotropy (FA) and mean diffusivity (MD) of each spinal root were extracted by two independent review authors. Generalised linear modelling was used to estimate the effect of experimental conditions on the FA and MD. Meta-analysis of root-level estimates was performed using Cohen’s method with random effects. Results Nine articles, describing 316 adults (1:1 male:female) of mean age 35 years (SD 6) were included. Increments of ten diffusion sensitising gradient directions reduced the mean FA by 0.01 (95% CI 0.01, 0.03). Each year of life reduced the mean MD by 0.03 × 10–3 mm2/s (95% CI 0.01, 0.04). At 3-T, the pooled mean FA of the roots was 0.36 (95% CI 0.34, 0.38; I2 98%). The pooled mean MD of the roots was 1.51 × 10–3 mm2/s (95% CI 1.45, 1.56; I2 99%). Conclusions The FA and MD of the roots of the brachial plexus vary according to experimental conditions and participant factors. We provide summary estimates of the normative values in different conditions which may be valuable to researchers and clinicians alike. Keywords Diffusion tensor · Brachial plexus · Normal · Normative · Healthy · Peripheral nerve
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40336-020-00393-x) contains supplementary material, which is available to authorized users. * Ryckie G. Wade [email protected] 1
The brachial plexus is a network of nerves which supply the upper limb with movement and feeling (Fig. 1 and Supplementary Fig. 1). Magnetic resonance imaging (MRI) is generally considered the best non-invasive imaging modality for
5
Department of Integrative Medical Biology, Faculty of Medicine, Umeå University, Umeå, Sweden
6
Department of Surgical and Perioperative Science, Section for Hand and Plastic Surgery, Umeå University, Umeå, Sweden
Department of Plastic and Reconstructive Surgery, Leeds Teaching Hospitals Trust, Leeds LS1 3EX, UK
2
Leeds Institute for Medical Research, University of Leeds, Leeds, UK
7
3
Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
Department of Neurological Surgery, University of Pitt
Data Loading...
