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High-Frequency Peripheral Nerve Ultrasound

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Musculoskeletal Ultrasound-Guided Regenerative Medicine

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Abstract

Innovations in high-frequency ultrasound have resulted in it becoming the imaging modality of choice for most peripheral nerves. Its advantages include high resolution, portability, and relatively low cost. The anatomic information provided is an excellent adjunct to electrophysiologic techniques for the assessment of disorders of peripheral nerves, and ultrasound can be effectively integrated with electrodiagnosis in a clinical setting. Knowledge of scanning techniques and image interpretation can lead to successful evaluations of both focal and generalized neuropathies. Ultrasound is also the ideal imaging modality for guided peripheral nerve procedures.

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References

  1. Akcar N, Ozkan S, Mehmetoglu O, Calisir C, Adapinar B. Value of power Doppler and gray-scale US in the diagnosis of carpal tunnel syndrome: contribution of cross-sectional area just before the tunnel inlet as compared with the cross-sectional area at the tunnel. Korean J Radiol. 2010;11(6):632–9. Epub 2010 Oct 29

    Article  PubMed  PubMed Central  Google Scholar 

  2. Alemán L, Berná JD, Reus M, Martínez F, Doménech-Ratto G, Campos M. Reproducibility of sonographic measurements of the median nerve. J Ultrasound Med. 2008;27(2):193–7.

    Article  PubMed  Google Scholar 

  3. Ali ZS, Pisapia JM, Ma TS, Zager EL, Heuer GG, Khoury V. Ultrasonographic evaluation of peripheral nerves. World Neurosurg. 2016;85:333–9.

    Article  PubMed  Google Scholar 

  4. Bianchi S. Ultrasound of the peripheral nerves. Joint Bone Spine. 2008;75(6):643–9.

    Article  PubMed  Google Scholar 

  5. Bianchi S, Martinoli C. Ultrasound of the musculoskeletal system. Heidelberg: Springer-Verlag; 2007.

    Book  Google Scholar 

  6. 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(7):1446–53.

    Article  CAS  PubMed  Google Scholar 

  7. Boon AJ, Oney-Marlow TM, Murthy NS, Harper CM, McNamara TR, Smith J. Accuracy of electromyography needle placement in cadavers: non-guided vs. ultrasound guided. Muscle Nerve. 2011;44(1):45–9.

    Article  PubMed  Google Scholar 

  8. Cartwright MS, Baute V, Caress JB, Walker FO. Ultrahigh-frequency ultrasound of fascicles in the median nerve at the wrist. Muscle Nerve. 2017;56(4):819–22.

    Article  PubMed  Google Scholar 

  9. Cartwright MS, Shin HW, Passmore LV, Walker FO. Ultrasonographic findings of the normal ulnar nerve in adults. Arch Phys Med Rehabil. 2007;88(3):394–6.

    Article  PubMed  Google Scholar 

  10. Chiou HJ, Chou YH, Chiou SY, Liu JB, Chang CY. Peripheral nerve lesions: role of high-resolution US. Radiographics. 2003;23(6):e15. Epub 2003 Aug 25

    Article  PubMed  Google Scholar 

  11. Connolly D, Berman L, McNally E. The use of beam angulation to overcome anisotropy when viewing human tendon with high frequency linear array ultrasound. Br J Radiol. 2001;74:183–5.

    Article  CAS  PubMed  Google Scholar 

  12. Cre’teur V, Bacq C, Widelec J. Sonography of peripheral nerves. Part I: upper limbs. J Radiol. 2004;85:1887e99.

    Google Scholar 

  13. Créteur V, Bacq C, Fumière E, Bissen L, Delcour C. Echographie des nerfs périphériques – Deuxième partie: membre inférieur [Sonography of peripheral nerves. Part II: lower limbs]. J Radiol. 2007;88(3 Pt 1):349–60.

    Article  PubMed  Google Scholar 

  14. Dahlin LB. Aspects on pathophysiology of nerve entrapments and nerve compression injuries. Neurosurg Clin N Am. 1991;2(1):21–9.

    Article  CAS  PubMed  Google Scholar 

  15. Dumitru D, Amato AA, Zwarts MJ. Electrodiagnostic medicine. 2nd edn. Hanley & Belfus. Dumitru, Philadelphia. 2002.

    Google Scholar 

  16. Duncan I, Sullivan P, Lomas F. Sonography in the diagnosis of carpal tunnel syndrome. AJR Am J Roentgenol. 1999;173:681–4.

    Article  CAS  PubMed  Google Scholar 

  17. El-Karabaty H, Hetzel A, Galla TJ, Horch RE, Lücking CH, Glocker FX. The effect of carpal tunnel release on median nerve flattening and nerve conduction. Electromyogr Clin Neurophysiol. 2005;45(4):223–7.

    CAS  PubMed  Google Scholar 

  18. Ghasemi-Esfe AR, Khalilzadeh O, Mazloumi M, et al. Combination of high-resolution and color Doppler ultrasound in diagnosis of carpal tunnel syndrome. Acta Radiol. 2011;52:191–7.

    Article  PubMed  Google Scholar 

  19. Johnson EW. The EMG examination. In: Johnson EW, editor. Practical electromyography. Baltimore: Williams & Wilkins; 1988. p. 1–12.

    Google Scholar 

  20. Grimm A, Décard BF, Bischof A, Axer H. Ultrasound of the peripheral nerves in systemic vasculitic neuropathies. J Neurol Sci. 2014;347(1–2):44–9.

    Article  PubMed  Google Scholar 

  21. Kimura J. Electromyography and nerve stimulation techniques: clinical applications. Tokyo: Igaku-Shoin; 1990.

    Google Scholar 

  22. Kimura J. Electrodiagnosis in diseases of nerve and muscle: principles and practice. 4th ed. Oxford University Press; Kimura - New York. 2013.

    Google Scholar 

  23. Koenig RW, Pedro MT, Heinen CP, Schmidt T, Richter HP, Antoniadis G, Kretschmer T. High-resolution ultrasonography in evaluating peripheral nerve entrapment and trauma. Neurosurg Focus. 2009;26(2)

    Google Scholar 

  24. Kremkau FW. Diagnostic ultrasound: principles and ultrasound. St. Louis: Sauders; 2002.

    Google Scholar 

  25. Lawande AD, Warrier SS, Joshi MS. Role of ultrasound in evaluation of peripheral nerves. Indian J Radiol Imaging. 2014;24(3):254–8.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Lee H, Brekelmans GJ, Visser LH. Quantitative assessment of nerve echogenicity as an additional tool for evaluation of common fibular neuropathy. Clin Neurophysiol. 2016;127(1):874–9.

    Article  PubMed  Google Scholar 

  27. Lento PH, Strakowski JA. The use of ultrasound in guiding musculoskeletal interventional procedures. Phys Med Rehabil Clin N Am. 2010;21(3):559–83.

    Article  PubMed  Google Scholar 

  28. Lucchetta M, Pazzaglia C, Granata G, Briani C, Padua L. Ultrasound evaluation of peripheral neuropathy in POEMS syndrome. Muscle Nerve. 2011;44(6):868–72.

    Article  PubMed  Google Scholar 

  29. Mahmood FH, Strakowski JA, Bockbrader MA, Kim D. Accuracy and reliability of peripheral nerve diameter measurement in long axis. J PM&R. 2013;5(9):S217–8.

    Article  Google Scholar 

  30. Martinoli C, Bianchi S, Dahmane M, Pugliese F, Bianchi-Zamorani MP, Valle M. Ultrasound of tendons and nerves. Eur Radiol. 2002;12(1):44–55. Epub 2001 Oct 19

    Article  PubMed  Google Scholar 

  31. Martinoli C, Bianchi S, Derchi LE. Tendon and nerve sonography. Radiol Clin N Am. 1999;37(4):691–711, viii.

    Article  CAS  PubMed  Google Scholar 

  32. Martinoli C, Bianchi S, Gandolfo N, Valle M, Simonetti S, Derchi LE. US of nerve entrapments in osteofibrous tunnels of the upper and lower limbs. Radiographics. 2000;20 Spec No:S199–213; discussion S213–7.

    Google Scholar 

  33. Matsuoka N, Kohriyama T, Ochi K, Nishitani M, Sueda Y, Mimori Y, Nakamura S, Matsumoto M. Detection of cervical nerve root hypertrophy by ultrasonography in chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Sci. 2004;219(1–2):15–21.

    Article  PubMed  Google Scholar 

  34. Melvin JL, Schuchman JA, Lanese RR. Diagnostic specificity of motor and sensory nerve conduction variables in the carpal tunnel. Arch Phys Med Rehabil. 1973;54:69–74.

    CAS  PubMed  Google Scholar 

  35. Mizuno K, Nagamatsu M, Hattori N, Yamamoto M, Goto H, Kuniyoshi K, Sobue G. Chronic inflammatory demyelinating polyradiculoneuropathy with diffuse and massive peripheral nerve hypertrophy: distinctive clinical and magnetic resonance imaging features. Muscle Nerve. 1998;21(6):805–8.

    Article  CAS  PubMed  Google Scholar 

  36. Moran L, Perez M, Esteban A, Bellon J, Arranz B, del Cerro M. Sonographic measurement of cross-sectional area of the median nerve in the diagnosis of carpal tunnel syndrome: correlation with nerve conduction studies. J Clin Ultrasound. 2009;37(3):125–31.

    Article  PubMed  Google Scholar 

  37. Nakamichi K, Tachibana S. Ultrasonographic measurement of median nerve cross-sectional area in idiopathic carpal tunnel syndrome: diagnostic accuracy. Muscle Nerve. 2002;26(6):798–803.

    Article  PubMed  Google Scholar 

  38. Nazarian LN. The top 10 reasons musculoskeletal sonography is an important complementary or alternative technique to MRI. AJR Am J Roentgenol. 2008;190(6):1621–6.

    Article  PubMed  Google Scholar 

  39. Nwawka OK, Miller TT. Ultrasound-guided peripheral nerve injection techniques. AJR Am J Roentgenol. 2016;207(3):507–16.

    Article  PubMed  Google Scholar 

  40. Padua L, Paolasso I, Pazzaglia C, Granata G, Lucchetta M, Erra C, Coraci D, De Franco P, Briani C. High ultrasound variability in chronic immune-mediated neuropathies. Review of the literature and personal observations. Rev Neurol (Paris). 2013;169(12):984–90.

    Article  CAS  Google Scholar 

  41. Pease WS, Lew HL, Johnson EW. Johnson’s practical electromyography. Lippincott Williams & Wilkins; Baltimore. 2007.

    Google Scholar 

  42. Peer S, Bodner G, editors. High-resolution sonography of the peripheral nervous system. 2nd ed. Berlin: Springer-Verlag; 2008.

    Google Scholar 

  43. Raynor EM, Ross MH, Shefner JM, Preston DC. Differentiation between axonal and demyelinating neuropathies: identical segments recorded from proximal and distal muscles. Muscle Nerve. 1995;18:402–8.

    Article  CAS  PubMed  Google Scholar 

  44. Robinson LR. Traumatic injury to peripheral nerves. Muscle Nerve. 2000;23:863–73.

    Article  CAS  PubMed  Google Scholar 

  45. 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;37:1539–53.

    Article  PubMed  Google Scholar 

  46. Rubin JM. Musculoskeletal power doppler. Eur Radiol. 1999;9(Suppl 3):S403–6.

    Article  PubMed  Google Scholar 

  47. 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(1):291–6.

    Article  CAS  PubMed  Google Scholar 

  48. Strakowski JA. Ultrasound evaluation of focal neuropathies: correlation with electrodiagnosis. New York: Demos Medical Publishing; 2013.

    Book  Google Scholar 

  49. Strakowski JA. Introduction to musculoskeletal ultrasound: getting started. New York: Demos Medical Publishing; 2015.

    Book  Google Scholar 

  50. Strakowski JA. Ultrasound-guided peripheral nerve procedures. Phys Med Rehabil Clin N Am. 2016;27(3):687–715.

    Article  PubMed  Google Scholar 

  51. Suk JI, Walker FO, Cartwright MS. Ultrasound of peripheral nerves. Curr Neurol Neurosci Rep. 2013;13(2):328.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Tagliafico AS. Peripheral nerve imaging: not only cross-sectional area. World J Radiol. 2016;8(8):726–8.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Walker FO, Cartwright MS. Neuromuscular ultrasound. Philadelphia: Elsevier Saunders; 2011.

    Google Scholar 

  54. Tagliafico A, Bodner G, Rosenberg I, et al. Peripheral nerves: ultrasound-guided interventional procedures. Semin Musculoskelet Radiol. 2010;14(5):559–66.

    Article  PubMed  Google Scholar 

  55. Taniguchi N, Itoh K, Wang Y, Omoto K, Shigeta K, Fujii Y, Namekawa M, Muramatsu S, Nakano I. Sonographic detection of diffuse peripheral nerve hypertrophy in chronic inflammatory demyelinating polyradiculoneuropathy. J Clin Ultrasound. 2000;28(9):488–91.

    Article  CAS  PubMed  Google Scholar 

  56. Tazawa K, Matsuda M, Yoshida T, Shimojima Y, Gono T, Morita H, Kaneko T, Ueda H, Ikeda S. Spinal nerve root hypertrophy on MRI: clinical significance in the diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy. Intern Med. 2008;47(23):2019–24.

    Article  PubMed  Google Scholar 

  57. Walker FO, Cartwright MS, Alter KE, Visser LH, Hobson-Webb LD, Padua L, Strakowski JA, Preston DC, Boon AJ, Axer H, van Alfen N, Tawfik EA, Wilder-Smith E, Yoon JS, Kim BJ, Breiner A, Bland JDP, Grimm A, Zaidman CM. Indications for neuromuscular ultrasound: expert opinion and review of the literature. Clin Neurophysiol. 2018;129(12):2658–79.

    Article  PubMed  Google Scholar 

  58. Walker FO, Cartwright MS, Wiesler ER, Caress J. Ultrasound of nerve and muscle. Clin Neurophysiol. 2004;115(3):495–507.

    Article  PubMed  Google Scholar 

  59. Watanabe T, Ito H, Sekine A, Katano Y, Nishimura T, Kato Y, Takeda J, Seishima M, Matsuoka T. 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(5):697–708.

    Article  PubMed  Google Scholar 

  60. Wiesler ER, Chloros GD, Cartwright MS, Smith BP, Rushing J, Walker FO. The use of diagnostic ultrasound in carpal tunnel syndrome. J Hand Surg [Am]. 2006;31(5):726–32.

    Article  Google Scholar 

  61. Wilbourn AJ. Nerve conduction study changes in human nerves undergoing Wallerian degeneration. Neurology. 1981;31:96–7.

    Google Scholar 

  62. Wilder-Smith EP, Therimadasamy A, Ghasemi-Esfe AR, Khalilzadeh O. Color and power Doppler US for diagnosing carpal tunnel syndrome and determining its severity. Radiology. 2012;262(3):1043–4. author reply 1044

    Article  PubMed  Google Scholar 

  63. Yoon JS, Walker FO, Cartwright MS. Ultrasonographic swelling ratio in the diagnosis of ulnar neuropathy at the elbow. Muscle Nerve. 2008;38:1231–5.

    Article  PubMed  Google Scholar 

  64. Zaidman CM, Al-Lozi M, Pestronk A. Peripheral nerve size in Normals and patients with polyneuropathy: an ultrasound study. Muscle Nerve. 2009;40:960–6.

    Article  PubMed  Google Scholar 

  65. Zaidman CM, Seelig MJ, Baker JC, Mackinnon SE, Pestronk A. Detection of peripheral nerve pathology: comparison of ultrasound and MRI. Neurology. 2013;80(18):1634–40.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of PM&R, The Ohio State University, OhioHealth Riverside Methodist Hospital, Columbus, OH, USA

    Jeffrey A. Strakowski

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  1. Institute of Medical Sciences, Canterbury Christ Church University, Canterbury, Kent, UK

    Yasser El Miedany

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Strakowski, J.A. (2022). High-Frequency Peripheral Nerve Ultrasound. In: El Miedany, Y. (eds) Musculoskeletal Ultrasound-Guided Regenerative Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-98256-0_16

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  • DOI: https://doi.org/10.1007/978-3-030-98256-0_16

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