Localization of Schwannomas Within the Brachial Plexus for Planning of Tumor Resection

Animation: Position of schwannoma in brachial plexus in patient with asymptomatic palpable neck mass.

The oblique coronal view (A)  allows counting and identification of the cervical spinal nerves and establishes that only the C5 root is involved with this Schwannoma. "Nerve perpendicular" image slices can be obtained by using the image from the oblique coronal view to depict the direction of travel of the nerve trunks near the tumor.

The resulting oblique sagittal (B) view demonstrates each of the cervical spinal nerves in cross section and demonstrates their relationship to the tumor.

(C)  Relationship of nerve trunks to tumor. The surgical approach and risks of nerve injury can be greatly influenced by the relative position of nerve and tumor. In many cases, MR Neurography allows the position of the traversing nerve elements relative to the tumor can be clearly established in advance of surgery. This is a "nerve perpendicular" image in which a double oblique image orientation is prescribed so that the image plane crosses most of the plexus elements at right angles in the region of interest.

Nerve Tumor Information
Anterior Leg Pain from Schwannoma
Sciatic Nerve Tumors Presenting as Sciatica
Multiple Nerve Tumors in Neurofibromatosis
Brachial Plexus Nerve Tumors