J Reconstr Microsurg 2005; 21(7): 429-433
DOI: 10.1055/s-2005-918894
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Intraoperative Imaging of the Brachial Plexus by High-Resolution Ultrasound

H. Kubiena1 , M. Hörmann2 , W. Michlits1 , M. Tschabitscher3 , K. Groszschmidt4 , M. Frey1
  • 1Division of Plastic and Reconstructive Surgery, Department of Surgery
  • 2Department of Radiology
  • 3Institute of Anatomy I
  • 4Institute of Histology, University of Vienna Medical School, Austria
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Publikationsverlauf

Accepted: June 7, 2005

Publikationsdatum:
30. September 2005 (online)

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ABSTRACT

The authors attempted to perform direct high resolution ultrasound imaging of the intraneural ultrastructure of the brachial plexus for intraoperative image guidance in brachial plexus surgery. The brachial plexuses of four fresh-frozen cadaver specimens were surgically exposed in a standard approach used in routine brachial plexus surgery to undergo direct ultrasound examination using a 15 MHz SonoCT® scanhead. By placing the scanhead directly onto the epineurium, all components of the brachial plexus were directly visualized in an axial plane and compared with histologic findings. The internal neural structure at different levels could be visualized in high resolution, showing the specific fascicular pattern. The histologic processing revealed good correlation with the intraneural topography demonstrated on ultrasound. In the study, high resolution ultrasound examination of the brachial plexus showed substantial details of the ultrastructure of neural tissue, which may play a role in intraoperative image guidance in the surgical treatment of patients with brachial plexopathy.

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