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Ultrasound and EMG–NCV study (electromyography and nerve conduction velocity) correlation in diagnosis of nerve pathologies

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Abstract

Purpose

Nerve disorders are commonly encountered in clinical practice. Ultrasonography (USG) is a useful modality in the evaluation of most of the peripheral and superficial pathologies amenable to penetration by ultrasound. The primary objective is to study the USG findings of various peripheral nerve pathologies and to correlate them with electrophysiological (EMG–NCV) findings.

Method

42 patients referred with suspicion of peripheral nervous system affection were evaluated with USG along with EMG–NCV. After reviewing detailed anatomy of the region, the affected nerve was visualized along the major neurovascular bundle or at a known anatomical landmark with a high-frequency (9–20 MHz) linear/hockey stick transducer.

Results

The USG parameters, namely loss of fibrillary pattern, hypoechogenicity and nerve thickening, showed significant p value (p < 0.05) on the tests of significance, suggesting these parameters are significant predictors of nerve affection/pathology on USG. Each ultrasound parameter was correlated individually with SNAP and CMAP. The results revealed positive correlation of echogenicity (r = 0.210, p = 0.05), fibrillary pattern (r = 0.209, p = 0.05) and thickening (r = 0.387, p < 0.05) with sensory nerve action potential (SNAP) and compound muscle action potential (CMAP).

Conclusion

USG can be used as corroborative investigation to strengthen the findings of EMG–NCV. This combination represents a powerful tool in enabling appropriate planning for treatment, preventing unnecessary intervention and thus improving overall outcomes in patients with peripheral neuropathy.

Sommario

Obiettivo

le malattie neurologiche periferiche sono comuni nella pratica clinica. L’ ecografia (US) è una modalità utile nella valutazione della maggior parte delle patologie periferiche e superficiali. L’ obiettivo primario del lavoro è studiare i reperti delle varie patologie del nervo periferico e correlarli con quelli elettrofisiologici (EMG–NCV).

Metodo

42 Pazienti con sospette patologie del sistema nervoso periferico sono stati valutati con US ed EMG–NCV. Dopo un dettagliato studio anatomico della regione, il nervo affetto è stato visualizzato lungo tutto il fascio neurovascolare o in prossimità di un repere anatomico noto, con una sonda lineare/hockey stick ad alta frequenza (9-20 MHz).

Risultati

alcuni parametri ecografici quali la perdita del pattern fibrillare, l’ ipoecogenicità e l’ ispessimento del nervo hanno mostrato un p value significativo (p < 0.05), suggerendo che essi sono indicatrori ecografici affidabili della patologia dei nervi. Ogni parametro ecografico è stato correlato singolarmente con il SNAP ed il CMAP. I risultati hanno rivelato una correlazione positiva tra ecogenicità (r = 0.210; p = 0.05), pattern fibrillare (r = 0.209; p = 0.05), ispessimento (r = 0.387; p < 0.05) ed il potenziale d’ azione del nervo sensitivo (SNAP) ed il potenziale d’ azione della componente muscolare.

Conclusioni

L’ ecografia può essere utilizzata come strumento diagnostico aggiuntivo per aumentare l’accuratezza dei reperti EMG–NCV. Questa combinazione rappresenta un valido strumento al fine di programmare il trattamento, prevenire interventi non necessari e conseguentemente migliorare l’ outcome dei Pazienti con neuropatia periferica.

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Authors and Affiliations

  1. Sir J.J. Hospital, Mumbai, India

    Shilpa Domkundwar, Gayatri Autkar & S. V. Khadilkar

  2. Sir H.N. Reliance Foundation Hospital, Mumbai, India

    Mayur Virarkar

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  1. Shilpa Domkundwar
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  2. Gayatri Autkar
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  3. S. V. Khadilkar
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  4. Mayur Virarkar
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Correspondence to Shilpa Domkundwar.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Domkundwar, S., Autkar, G., Khadilkar, S.V. et al. Ultrasound and EMG–NCV study (electromyography and nerve conduction velocity) correlation in diagnosis of nerve pathologies. J Ultrasound 20, 111–122 (2017). https://doi.org/10.1007/s40477-016-0232-3

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  • DOI: https://doi.org/10.1007/s40477-016-0232-3

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