DOI QR코드

DOI QR Code

A beginner's guide to peripheral nerve ultrasound

  • Seok, Jung Im (Department of Neurology, School of Medicine, Catholic University of Daegu)
  • Received : 2022.08.08
  • Accepted : 2022.09.01
  • Published : 2022.10.30

Abstract

Ultrasonography is currently being developed as a tool for evaluating peripheral neuropathy. It is one of the painless and least-invasive methods of medical diagnostic testing that yields anatomic views of the nerves and their surrounding structures. Here I first describe the equipment settings and technique for nerve ultrasound along with typical sonographic findings for normal nerves. I then address frequently used parameters for nerve measurements that facilitate diagnoses of focal and generalized neuropathies.

Keywords

References

  1. Walker FO, Cartwright MS, Wiesler ER, Caress J. Ultrasound of nerve and muscle. Clin Neurophysiol 2004;115:495-507. https://doi.org/10.1016/j.clinph.2003.10.022
  2. Suk JI, Walker FO, Cartwright MS. Ultrasonography of peripheral nerves. Curr Neurol Neurosci Rep 2013;13:328. https://doi.org/10.1007/s11910-012-0328-x
  3. Silvestri E, Martinoli C, Derchi LE, Bertolotto M, Chiaramondia M, Rosenberg I. Echotexture of peripheral nerves: correlation between US and histologic findings and criteria to differentiate tendons. Radiology 1995;197:291-296. https://doi.org/10.1148/radiology.197.1.7568840
  4. Duncan I, Sullivan P, Lomas F. Sonography in the diagnosis of carpal tunnel syndrome. AJR Am J Roentgenol 1999;173:681-684. https://doi.org/10.2214/ajr.173.3.10470903
  5. Roll SC, Case-Smith J, Evans KD. Diagnostic accuracy of ultrasonography vs. electromyography in carpal tunnel syndrome: a systematic review of literature. Ultrasound Med Biol 2011;37:1539-1553. https://doi.org/10.1016/j.ultrasmedbio.2011.06.011
  6. Beekman R, Visser LH, Verhagen WI. Ultrasonography in ulnar neuropathy at the elbow: a critical review. Muscle Nerve 2011;43:627-635. https://doi.org/10.1002/mus.22019
  7. Seok JI, Lee SB, Bae CB. Ultrasonographic findings of the normal nerves in common entrapment site; cross-sectional area reference value and normal variant. J Korean Neurol Assoc 2015;33:8-12. https://doi.org/10.17340/jkna.2015.1.2
  8. Beekman R, Visser LH. Sonography in the diagnosis of carpal tunnel syndrome: a critical review of the literature. Muscle Nerve 2003;27:26-33. https://doi.org/10.1002/mus.10227
  9. Beekman R, Van Der Plas JP, Uitdehaag BM, Schellens RL, Visser LH. Clinical, electrodiagnostic, and sonographic studies in ulnar neuropathy at the elbow. Muscle Nerve 2004;30:202-208. https://doi.org/10.1002/mus.20093
  10. Yoon JS, Walker FO, Cartwright MS. Ultrasonographic swelling ratio in the diagnosis of ulnar neuropathy at the elbow. Muscle Nerve 2008;38:1231-1235. https://doi.org/10.1002/mus.21094
  11. Hobson-Webb LD, Massey JM, Juel VC, Sanders DB. The ultrasonographic wrist-to-forearm median nerve area ratio in carpal tunnel syndrome. Clin Neurophysiol 2008;119:1353-1357. https://doi.org/10.1016/j.clinph.2008.01.101
  12. Cho JM, Yoon JS, Kim SJ, Park BK, Lee GH, Jeong JS. Feasibility of ultrasonographic area ratio of median nerve in the diagnosis of carpal tunnel syndrome in Korea. J Korean Acad Rehabil Med 2009;33:627-631.
  13. Bathala L, Kumar P, Kumar K, Shaik A, Visser LH. Normal values of median nerve cross-sectional area obtained by ultrasound along its course in the arm with electrophysiological correlations, in 100 Asian subjects. Muscle Nerve 2014;49:284-286. https://doi.org/10.1002/mus.23912
  14. Mallouhi A, Pulzl P, Trieb T, Piza H, Bodner G. Predictors of carpal tunnel syndrome: accuracy of gray-scale and color Doppler sonography. AJR Am J Roentgenol 2006;186:1240-1245. https://doi.org/10.2214/AJR.04.1715
  15. Martinoli C, Bianchi S, Zamorani MP, Zunzunegui JL, Derchi LE. Ultrasound of the elbow. Eur J Ultrasound 2001;14:21-27. https://doi.org/10.1016/S0929-8266(01)00142-2
  16. Boom J, Visser LH. Quantitative assessment of nerve echogenicity: comparison of methods for evaluating nerve echogenicity in ulnar neuropathy at the elbow. Clin Neurophysiol 2012;123:1446-1453. https://doi.org/10.1016/j.clinph.2011.10.050
  17. Watanabe T, Ito H, Sekine A, Katano Y, Nishimura T, Kato Y, et al. Sonographic evaluation of the peripheral nerve in diabetic patients: the relationship between nerve conduction studies, echo intensity, and cross-sectional area. J Ultrasound Med 2010;29:697-708. https://doi.org/10.7863/jum.2010.29.5.697
  18. Tagliafico A, Tagliafico G, Martinoli C. Nerve density: a new parameter to evaluate peripheral nerve pathology on ultrasound. Preliminary study. Ultrasound Med Biol 2010;36:1588-1593. https://doi.org/10.1016/j.ultrasmedbio.2010.07.009
  19. Ghasemi-Esfe AR, Khalilzadeh O, Vaziri-Bozorg SM, Jajroudi M, Shakiba M, Mazloumi M, et al. Color and power Doppler US for diagnosing carpal tunnel syndrome and determining its severity: a quantitative image processing method. Radiology 2011;261:499-506. https://doi.org/10.1148/radiol.11110150
  20. Sernik RA, Abicalaf CA, Pimentel BF, Braga-Baiak A, Braga L, Cerri GG. Ultrasound features of carpal tunnel syndrome: a prospective case-control study. Skeletal Radiol 2008;37:49-53.
  21. Erel E, Dilley A, Greening J, Morris V, Cohen B, Lynn B. Longitudinal sliding of the median nerve in patients with carpal tunnel syndrome. J Hand Surg Br 2003;28:439-443.
  22. Wang Y, Filius A, Zhao C, Passe SM, Thoreson AR, An KN, et al. Altered median nerve deformation and transverse displacement during wrist movement in patients with carpal tunnel syndrome. Acad Radiol 2014;21:472-480. https://doi.org/10.1016/j.acra.2013.12.012
  23. Seok JI, Lee DK. Physiological factors influencing median nerve mobility in normal subjects. Muscle Nerve 2016;54:883-886. https://doi.org/10.1002/mus.25128
  24. Ozturk E, Sonmez G, Colak A, Sildiroglu HO, Mutlu H, Senol MG, et al. Sonographic appearances of the normal ulnar nerve in the cubital tunnel. J Clin Ultrasound 2008;36:325-329. https://doi.org/10.1002/jcu.20486