Brachial Plexus Contouring

This is the page for Brachial Plexus Contouring session.
You can contour the brachial plexus as follows:

  1. Identify the C5 vertebrae and the neural foramina of the vertebra
  2. Window setting - Mediastinum adjusting fat to be black so that the fat space between the muscles become evident.
  3. Use a 5 mm static brush to contour the brachial plexus:
    1. Start from the lateral aspect of the spinal canal
    2. Along the neural foramina
    3. Laterally upto the fat space that forms the level III
    4. Along the lateral processes of the vertebrae (thats where the spinal nerves exit)
    5. Direction antero lateral
    6. Contour the fat space that is posterolateral to the anterior scalene muscle
  4. In the lower slices there will be slices where there is no neural foramina .. in them just contour upto the vertebral body
  5. In the slices where you see the neural foramina extend contour inside. Typically this will be seen every 4 slices in a 2 mm thick slice CT
  6. After the first rib starts the contour ends medial to the first rib

If you have contoured it all right then there will be four roots coming out alongside the C5, C6, C7 & T1.. see that in the TPS using the topogram view
Practice the contouring below. Please leave your comments below. You can use any name you want including guest.. and no requirements for a password. The contour on the left is "standard" - however if you see a mistake feel free to correct it and tell us why you think its wrong like pranshu did in the comments below. Please remember we are also trainees .. so in case you spot a glaring error correct us

For references and additional comments please see Pranshu's valuable comments below

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