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Radiation Associated Changes in a Patient With Breast Cancer

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So, this was a patient that had left-sided

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breast cancer and was treated with

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high-dose chemotherapy and radiation therapy.

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So, again, the abnormality was on the left side.

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So, again, when I start looking at the

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brachial plexus, the first thing that I

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have to do is look at the normal side.

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So, on the right-hand side, we can see the

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normal appearance of the subclavian artery,

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and right above this, we can see the cords

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of the brachial plexus right below it.

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So, we can see that they are nice and thin.

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We can see a nice fat stripe between

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the superior portion of the subclavian

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artery and the inferior portion of

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the cords of the brachial plexus.

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Now, when we scroll and we start looking

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at the left side, what we end up seeing

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is that we can see the subclavian

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artery, but notice the brachial plexus.

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Notice how the brachial plexus is

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diffusely thickened, and there's not

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really a definable mass, rather, it's

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just, again, diffusely thickened, and I

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use the term it's almost glued together.

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And then when I look at the STIR

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sequences, what we see here is that

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there's actually abnormal signal. Again,

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involving the cords of the brachial

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plexus on the left compared to the right.

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So, we see the normal STIR signal on the left.

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Now, on the far-right image, again,

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this is a sequence that's optimized

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to look at the nerves themselves.

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And again, we can see very nice

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clarity of some of the exiting

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nerve roots from the spinal canal.

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But when we look at the brachial plexus on the

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left, again, we see diffuse abnormal thickening

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and abnormal enhancement of the brachial

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plexus in the high-dose radiation field.

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So this is an example, again, of radiation

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associated brachial plexopathy due

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to a neuritis that is associated with

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the radiation therapy that was given

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in this patient with breast cancer.

Report

Faculty

Suresh K Mukherji, MD, FACR, MBA

Clinical Professor, University of Illinois & Rutgers University. Faculty, Michigan State University. Director Head & Neck Radiology, ProScan Imaging

Tags

Neuroradiology

MRI

Head and Neck

Brachial Plexus

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