Correlation of MR Neurography and Electrophysiological Findings in Traumatic Plexus and Peripheral Nerve Injuries: A Case Series

Background: Traumatic injuries to the plexus and periph-eral nerves pose diagnostic challenges, particularly in differ-entiating transient conduction block from structural nerve damage. Magnetic resonance neurography (MRN) and electro-diagnostic studies (EMG/NCS) offer complementary insights, yet their correlation in clinical settings remains underexplored. Aim of Study: To assess the agreement between MR neu-rography grading and combined electrodiagnostic findings in patients with traumatic peripheral neuropathies and plexo-pathies. Patients and Methods: This descriptive case series in-cluded 24 patients with a history of trauma and clinical signs of neuropathy. All underwent MRN and EMG/NCS assess-ments. MRN findings were graded according to Sunderland’s scale. Electrophysiological data were combined to classify neuropathic severity. Agreement between MRN grades and electrodiagnostic findings was evaluated using Cohen’s kappa coefficient. Results: MRN grades ranged from I to V, reflecting vari-able severity. Electrodiagnostic studies identified severe mul-tiroot axonal neuropathy, focal entrapment, normal findings, and diffuse polyneuropathy. Perfect agreement was observed between MRN grading and combined electrophysiological findings (κ = 1.00). Higher MRN grades corresponded to more severe axonal involvement, while lower grades correlated with focal or mild abnormalities. Conclusion: MR neurography grading demonstrates ex-cellent concordance with electrophysiological assessments, supporting its utility as a complementary tool in the structur-al-functional evaluation of peripheral neuropathies. Larger studies are warranted to validate these findings and explore quantitative MRN metrics.