Introduction to High-Resolution Sonography of the Peripheral Nervous System: General Considerations and Examination Technique

Chapter

Abstract

Sonography of the peripheral nerve is not essentially new. As early as 1988, Bruno Fornage reported on the feasibility of peripheral nerve imaging (Fornage 1988). The progress of nerve sonography in the subsequent years, however, was slow, and this was mainly due to the fact that nerves are small structures and were not easy to approach with the then available technique. The lacking of high-resolution transducers was the main problem and therefore it took until the late 1990s and the first years of the new millennium for sonography of the peripheral nerve to experience a real boost, which still continues. While in the early era of peripheral nerve sonography actually only freaky guys were focusing on the then exotic area of nerve imaging – there were only very few groups worldwide really devoted to nerve sonography, such as the group around Carlo Martinoli and Stefano Bianchi in Genova, Italy, Leo Visser and Roy Beekman in the Netherlands, and our group in Innsbruck, Austria – meanwhile we experience a rising interest in peripheral nerve sonography from radiologists, neurologists, and anesthesiologists alike. This explosion of nerve sonography is also due to the fact that the unexpected technical progress of ultrasound scanners, transducers, and software development is amazing. Again, peripheral nerves are small and topographically complex structures and therefore a certain arsenal of tools is important to achieve constant high quality in diagnostic and interventional nerve ultrasound.

Keywords

Peripheral Nerve Ultrasound Scanner Image Compounding Compression Neuropathy Freehand Technique 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Beekman R, van den Berg LH, Franssen H et al (2005) Ultrasonography shows extensive nerve enlargements in multifocal motor neuropathy. Neurology 65:305–307PubMedCrossRefGoogle Scholar
  2. Bodner G, Huber B, Schwabegger A et al (1999) Sono­graphic detection of radial nerve entrapment within a humerus fracture. J Ultrasound Med 18:703–706PubMedGoogle Scholar
  3. Bradley MJ (2001) An in-vitro study to understand successful free-hand ultrasound guided intervention. Clin Radiol 56:495–498PubMedCrossRefGoogle Scholar
  4. Buchberger W, Schoen G, Strasser K et al (1991) High resolution ultrasonography of the carpal tunnel. J Ultrasound Med 101:531–537Google Scholar
  5. Burns PN, Powers JE, Hpe SD et al (1996) Harmonic imaging: principles and preliminary results. Angiology 47:63–69Google Scholar
  6. Chiou HJ, Chou YH, Cheng SP et al (1998) Cubital tunnel syndrome: diagnosis by high resolution ultrasonography. J Ultrasound Med 17:643–648PubMedGoogle Scholar
  7. Dahlin LB (1991) Aspects on pathophysiology of nerve entrapments and nerve compression injuries. Neurosurg Clin N Am 2:21–29PubMedGoogle Scholar
  8. Dodd GGD, Esola CC, Memel DS et al (1996) Sonography: the undiscovered jewel of interventional radiology. Radiographics 16:1271–1288PubMedGoogle Scholar
  9. Filler AG, Kliot M, Howe FA et al (1996) Application of magnetic resonance neurography in the evaluation of patients with peripheral nerve pathology. J Neurosurg 85:299–309PubMedCrossRefGoogle Scholar
  10. Fornage BD (1988) Peripheral nerves of the extremities: imaging with ultrasound. Radiology 167:179–182PubMedGoogle Scholar
  11. Ghasemi-Esfe AR, Khalizadeh O, Vaziri-Bozorg SM et al (2011) Color and power Doppler US for diagnosing carpal tunnel syndrome and determining its severity: a quantitative image processing method. Radiology 261:499–506PubMedCrossRefGoogle Scholar
  12. Graif M, Seton A, Nerubali J et al (1991) Sciatic nerve: sonographic evaluation and anatomic pathologic considerations. Radiology 181:405–408PubMedGoogle Scholar
  13. Gruber H, Kovacs P, Peer S, Marth R, Bodner G (2003) The ultrasonographic appearance of the femoral nerve and cases of iatrogenic impairment. J Ultrasound Med 22:163–172PubMedGoogle Scholar
  14. Gruber H, Peer S, Meirer R, Bodner G (2005) Peroneal nerve palsy associated with knee luxation: evaluation by sonography-initial experiences. Am J Roentgenol 185:1119–1125CrossRefGoogle Scholar
  15. Hopkins RE, Bradley M (2001) In-vitro visualization of biopsy needles with ultrasound: a comparative study of standard and echogenic needles using an ultrasound phantom. Clin Radiol 56:499–502PubMedCrossRefGoogle Scholar
  16. Mallouhi A, Pülzl P, Trieb T, Pizza H, Bodner G (2006) Predictors of carpal tunnel syndrome: accuracy of gray-scale and color Doppler sonography. AJR Am J Roentgenol 186:1240–1245PubMedCrossRefGoogle Scholar
  17. Maravilla KR, Bowen BC (1998) Imaging of the peripheral nervous system: evaluation of peripheral neuropathy and plexopathy. AJNR Am J Neuroradiol 19: 1011–1023PubMedGoogle Scholar
  18. Martinoli C, Serafini G, Bianchi S et al (1996) Ultrasonography of peripheral nerves. J Peripher Nerv Syst 1:169–174PubMedGoogle Scholar
  19. Narouze NN (2010) Atlas of ultrasound-guided procedures in interventional pain management. Springer, New York. doi: 10.1007/978-1-4419-1681-5 Google Scholar
  20. Peer S, Bodner G, Meirer R et al (2001) Evaluation of postoperative peripheral nerve lesions with high resolution ultrasound. AJR Am J Roentgenol 177:415–419PubMedGoogle Scholar
  21. Peer S, Kovacs P, Harpf C et al (2002) High resolution sonography of lower extremity peripheral nerves: anatomic correlation and spectrum of pathology. J Ultrasound Med 21:315–322PubMedGoogle Scholar
  22. Piccoli C, Merrit CRB, Forsberg F et al (2000) Real-time compound imaging of the breast. In: Presented at the annual meeting of the American Institute of Ultrasound in Medicine, San Francisco, April 2000Google Scholar
  23. Silvestri E, Martinoli C, Derchi LE et al (1995) Echotexture of peripheral nerves: correlation between US and histologic findings and criteria to differentiate tendons. Radiology 197:291–296PubMedGoogle Scholar
  24. Sites BD, Gallagher JD, Cravero J et al (2004) The learning curve associated with a simulated ultrasound-guided interventional task by inexperienced anesthesia residents. Reg Anesth Pain Med 29:544–548PubMedGoogle Scholar
  25. Takato I, Masanori K, Takashi W et al (2007) Ultrasonography of the tibial nerve in vasculitic neuropathy. Muscle Nerve 35:379–382CrossRefGoogle Scholar
  26. Walker FO, Cartwright MS, Wiesler ER, Caress J (2004) Ultrasound of nerve and muscle. Clin Neurophysiol 115:495–507PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.CTI GesmbHInnsbruckAustria

Personalised recommendations