High field strength MRI, with its excellent soft tissue contrast and multiplanar capabilities, allows good delineation of the brachial plexus. Normal anatomy of the brachial plexus is well demonstrated on coronal and sagittal images, and is best displayed on T1-weighted images. The sagittal oblique plane has the advantage of depicting the course of the brachial plexus in cross-section, the most reliable imaging plane for the visualization of the trunks, divisions, cords, and branches of the brachial plexus. Coronal and axial images are useful in demonstrating the long axis of the nerve plexus.
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The axial plane can give additional information about the nerve roots as they exit from their foramina. T2-weighted, fat-suppressed or STIR sequences are also important as they provide more specific tissue characterization . A normal nerve is round or ovoid in shape with distinctive internal fascicular architecture on transverse imaging, and no abrupt change in nerve calibre or course. Uniform, mildly hyperintense fascicles interspersed with hypointense, fibrofatty connective tissue are seen on fat-suppressed T2-weighted or STIR sequences, and hypointense fascicles within the hyperintense fibrofatty connective tissue on T1-weighted images.
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