Skip to main content
Log in

Ultraschall peripherer Nerven

  • Ultraschall—neue Entwicklungen
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

Aufgrund von Fortschritten der Breitbandschallkopftechnologie und der damit verbundenen Verfeinerung der Untersuchungstechnik lassen sich in zunehmendem Maße periphere Nerven und deren Erkrankungen sonographisch darstellen. Die hochauflösende Sonographie stellt eine Ergänzung der klinischen und elektrophysiologischen Untersuchungen bei einer Vielzahl von Nervenläsionen dar, wie z. B. Tunnelsyndromen, Traumata, Infektionen oder Tumoren. Weiterhin ist die Sonographie eine wertvolle Führungshilfe bei Regionalanästhesien oder perkutanen Behandlungen schmerzhafter Neurome. In diesem Artikel wird auf die Sonomorphologie der peripheren Nerven und die mögliche Rolle der Sonographie in der Diagnostik von Nervenerkrankungen eingegangen.

Abstract

With the recent advances in broadband transducer technology and refinements in scanning technique, an increasing number of nerves and related pathologic conditions are identified with sonography. High-resolution sonography can support clinical and electrophysiological testing for detection of a variety of nerve abnormalities, including entrapment neuropathies, traumas, infectious disorders, and tumors. In addition, procedures of regional anesthesia and percutaneous treatment of painful neuromas can be effectively guided by sonography in real time. This article addresses the normal US appearance of peripheral nerves and discusses the potential role of this technique to image nerve disorders in specific clinical settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1a-d
Abb. 2a, b
Abb. 3a-c
Abb. 4
Abb. 5a, b
Abb. 6
Abb. 7a-d
Abb. 8a, b
Abb. 9a, b
Abb. 10

Literatur

  1. Beggs I (1999) Sonographic appearances of nerve tumors. J Clin Ultrasound 27:363–368

    CAS  PubMed  Google Scholar 

  2. Bertolotto M, Rosenberg I, Parodi RC et al. (1996) Case report: fibroma of tendon sheath in the distal forearm with associated median nerve neuropathy: US, CT and MR appearance. Clin Radiol 51:370–372

    CAS  PubMed  Google Scholar 

  3. Bodner G, Buchberger W, Schocke M et al. (2001) Radial nerve palsy associated with humeral shaft fracture: evaluation with US: initial experience. Radiology 219:811–816

    CAS  PubMed  Google Scholar 

  4. Bodner G, Harpf C, Meirer R et al. (2002) Ultrasonographic appearance of supinator syndrome. J Ultrasound Med 21:1289–1293

    PubMed  Google Scholar 

  5. Bodner G, Harpf C, Gardetto A et al. (2002) Ultrasonography of the accessory nerve: normal and pathologic findings in cadavers and patients with iatrogenic accessory nerve palsy. J Ultrasound Med 21:1159–1163

    PubMed  Google Scholar 

  6. Bodner G, Huber B, Schwabegger A, Lutz M et al. (1999) Sonographic detection of radial nerve entrapment within a humerus fracture. J Ultrasound Med 20:131–136

    Article  CAS  Google Scholar 

  7. Buchberger W, Judmaier W, Birbamer G et al. (1992) Carpal tunnel syndrome: diagnosis with high-resolution sonography. AJR 159:793–798

    CAS  Google Scholar 

  8. Buchberger W, Schon G, Strasser K et al. (1991) High-resolution ultrasonography of the carpal tunnel. J Ultrasound Med 10:531–537

    CAS  PubMed  Google Scholar 

  9. Chen P, Maklad N, Redwine M et al. (1997) Dynamic high-resolution sonography of the carpal tunnel. AJR 168:533–537

    CAS  Google Scholar 

  10. Chen P, Massengill A, Maklad N et al. (1996) Nerve territory-oriented macrodactyly: unusual cause of carpal tunnel syndrome. J Ultrasound Med 15:661–664

    CAS  PubMed  Google Scholar 

  11. Chien AJ, Jamadar DA, Jacobson JA et al. (2003) Sonography and MR imaging of posterior interosseous nerve syndrome with surgical correlation. AJR 181:219–221

    Google Scholar 

  12. Chiou HJ, Chou YH, Cheng SP et al. (1998) Cubital tunnel syndrome: diagnosis by high-resolution ultrasonography. J Ultrasound Med 17:643–648

    CAS  PubMed  Google Scholar 

  13. Chiou HJ, Chou YH, Wu JJ et al. (1999) Alternative and effective treatment of shoulder ganglion cyst: ultrasonographically guided aspiration. J Ultrasound Med 18:531–535

    CAS  PubMed  Google Scholar 

  14. Chuang YM, Luo CB, Chou YH et al. (2002) Sonographic diagnosis and treatment of a median nerve epineural hematoma caused by brachial artery catheterization. J Ultrasound Med 21:705–708

    PubMed  Google Scholar 

  15. Duncan I, Sullivan P, Lomas F (1999) Sonography in the diagnosis of carpal tunnel syndrome. AJR 173:681–683

    CAS  Google Scholar 

  16. Ernberg LA, Adler RS, Lane J (2002) Ultrasound in the detection and treatment of a painful stump neuroma. Skeletal Radiol 32:306–209

    Google Scholar 

  17. Fornage BD (1988) Peripheral nerves of the extremities: imaging with US. Radiology 167:179–182

    CAS  PubMed  Google Scholar 

  18. Fornage BD, Nerot C (1987) Sonographic diagnosis of tuberculoid leprosy. J Ultrasound Med 6:105–107

    CAS  PubMed  Google Scholar 

  19. Gassner EM, Schocke M, Peer S et al. (2002) Persistent median artery in the carpal tunnel: color Doppler ultrasonographic findings. J Ultrasound Med 21:455–461

    PubMed  Google Scholar 

  20. Graif M, Seton A, Nerubali J et al. (1991) Sciatic nerve: sonographic evaluation and anatomic-pathologic considerations. Radiology 18:405–408

    Google Scholar 

  21. Gruber H, Peer S, Kovacs P et al. (2003) The ultrasonographic appearance of the femoral nerve and cases of iatrogenic impairment. J Ultrasound Med 22:163–172

    PubMed  Google Scholar 

  22. Hide IG, Grainger AJ, Naisby GP et al. (1999) Sonographic findings in the anterior interosseous nerve syndrome. J Clin Ultrasound 27:459–464

    Article  CAS  PubMed  Google Scholar 

  23. Hoddick WK, Callen PW, Filly RA et al. (1984) Ultrasound evaluation of benign sciatic nerve sheath tumors. J Ultrasound Med 3:505–507

    CAS  PubMed  Google Scholar 

  24. Hughes DG, Wilson DJ (1986) Ultrasound appearances of peripheral nerve tumors. BJR 59:1041–1043

    CAS  Google Scholar 

  25. Jacobson JA, Jebson PJL, Jeffers AW et al. (2001) Ulnar nerve dislocation and snapping triceps syndrome: diagnosis with dynamic sonography—report of three cases. Radiology 220:601–605

    CAS  PubMed  Google Scholar 

  26. Kapral S, Krafft P, Eibenberger K et al. (1994) Ultrasound-guided supraclavicular approach for regional anesthesia of the brachial plexus. Anesth Analg 78:507–513

    CAS  PubMed  Google Scholar 

  27. Keberle M, Jennett M, Kenn W et al. (2000) Technical advances in ultrasound and MR imaging of carpal tunnel syndrome. Eur Radiol 10:1043–1050

    CAS  PubMed  Google Scholar 

  28. King AD, Ahuja AT, King W et al. (1997) Sonography of peripheral nerve tumors of the neck. AJR 169:1695–1698

    CAS  PubMed  Google Scholar 

  29. Kirchmair L, Entner T, Kapral S et al. (2002) Ultrasound guidance for the psoas compartment block: an imaging study. Anesth Analg 94:706–710

    PubMed  Google Scholar 

  30. Kovacs P, Gruber H, Piegger J et al. (2001) New, simple ultrasound-guided infiltration of the pudendal nerve: ultrasonographic technique. Dis Colon Rectum 44:1381–1385

    CAS  PubMed  Google Scholar 

  31. Iannicelli E, Chianta GA, Salvini V et al. (2000) Evaluation of bifid median nerve with sonography and MR imaging. J Ultrasound Med 19:481–485

    CAS  PubMed  Google Scholar 

  32. Lee D, van Holsbeeck MT, Janevski PK et al. (1999) Diagnosis of carpal tunnel syndrome. Ultrasound versus electromyography. Radiol Clin North Am 37:859–872

    CAS  PubMed  Google Scholar 

  33. Lin J, Jacobson JA, Hayes CW (1999) Sonographic target sign in neurofibromas. J Ultrasound Med 18:513–517

    CAS  PubMed  Google Scholar 

  34. Lin J, Martel W (2001) Cross-sectional imaging of peripheral nerve sheath tumors: characteristic signs on CT, MR imaging, and sonography. AJR 176:75–82

    CAS  PubMed  Google Scholar 

  35. Martinoli C, Bianchi S, Derchi LE (1999) Tendon and nerve sonography. Radiol Clin North Am 37:691–711

    CAS  PubMed  Google Scholar 

  36. Martinoli C, Bianchi S, Derchi LE (2000) Ultrasonography of peripheral nerves. Seminars US CT MR 21:205–213

    CAS  Google Scholar 

  37. Martinoli C, Bianchi S, Gandolfo N et al. (2000) US of nerve entrapments in osteofibrous tunnels of the upper and lower limbs. RadioGraphics 20:199–217

    Google Scholar 

  38. Martinoli C, Bianchi S, Santacroce E et al. (2002) Brachial plexus sonography: a technique for assessing the root level. AJR 179:699–702

    Google Scholar 

  39. Martinoli C, Bianchi S, Prato N et al. (2003) US of the shoulder: non-rotator cuff disorders. RadioGraphics 23:381–401

    PubMed  Google Scholar 

  40. Martinoli C, Derchi LE, Bertolotto M et al. (2000) US and MR imaging of peripheral nerves in leprosy. Skeletal Radiol 29:142–150

    CAS  PubMed  Google Scholar 

  41. Martinoli C, Schenone A, Bianchi S et al. (2002) Sonography of median nerve in Charcot-Marie-Tooth disease. AJR 178:1553–1556

    Google Scholar 

  42. Martinoli C, Serafini G, Bianchi S et al. (1996) Ultrasonography of peripheral nerves. J Periph Nerv Syst 1:169–178

    CAS  Google Scholar 

  43. Murphey MD, Smith WS, Smith SE et al. (1999) Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. RadioGraphics 19:1253–1280

    CAS  PubMed  Google Scholar 

  44. Nakamichi K, Tachibana S (1995) Restricted motion of the median nerve in carpal tunnel syndrome. J Hand Surg [Br] 20:460–464

  45. Nakamichi K, Tachibana S, Kitajima I (2000) Ultrasonography in the diagnosis of ulnar tunnel syndrome caused by an occult ganglion. J Hand Surg [Br] 25:503–504

  46. Okamoto M, Abe M, Shirai H et al. (2000) Morphology and dynamics of the ulnar nerve in the cubital tunnel: observation by ultrasonography. J Hand Surg [Br] 25:85–89

  47. Ootaki C, Hayashi H, Amano M (2000) Ultrasound-guided infraclavicular brachial plexus block: an alternative technique to landmark-guided approaches. Reg Anesth Pain Med 25:600–604

    Article  CAS  PubMed  Google Scholar 

  48. Peer S, Bodner G, Mairer R et al. (2001) Examination of postoperative peripheral nerve lesions with high-resolution sonography. AJR 177:415–419

    CAS  Google Scholar 

  49. Propeck T, Quinn TJ, Jacobson JA et al. (2000) Sonography and MR imaging of bifid median nerve with anatomic and histologic correlation. AJR 175:1721–1725

    CAS  Google Scholar 

  50. Puig S, Turkof E, Sedivy R et al. (1999) Sonographic diagnosis of recurrent ulnar nerve compression by ganglion cysts. J Ultrasound Med 18:433–436

    CAS  PubMed  Google Scholar 

  51. Quinn TJ, Jacobson JA, Craig JG, van Holsbeeck MT (2000) Sonography of Morton’s neuromas. AJR 174:1723–1728

    CAS  Google Scholar 

  52. Rasmussen MR, Kitaoka HB, Patzer GL (1996) Nonoperative treatment of plantar interdigital neuroma with a single corticosteroid injection. Clin Orthop 326:188–193

    PubMed  Google Scholar 

  53. Read JW, Noakes JB, Kerr D et al. (1999) Morton’s metatarsalgia: sonographic findings and correlated histopathology. Foot Ankle Int 20:153–161

    CAS  PubMed  Google Scholar 

  54. Redd RA, Peters VJ, Emery SF et al. (1989) Morton neuroma: sonographic evaluation. Radiology 171:415–417

    CAS  PubMed  Google Scholar 

  55. Shafighi M, Gurunluoglu R, Ninkovic M et al. (2003) Ultrasonography for depiction of brachial plexus injury. J Ultrasound Med 22:631–634

    PubMed  Google Scholar 

  56. Sheppard DG, Iyer RB, Fenstermacher MJ (1998) Brachial plexus: demonstration at US. Radiology 208:402–406

    CAS  PubMed  Google Scholar 

  57. 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 197:291–296

    CAS  PubMed  Google Scholar 

  58. Simonetti S, Bianchi S, Martinoli C (1999) Neurophysiological and ultrasound findings in sural nerve lesions following stripping of the small saphenous vein. Muscle Nerve 22:1724–1726

    Article  CAS  PubMed  Google Scholar 

  59. Sobiesk GA, Wertheimer SJ, Schulz R et al. (1997) Sonographic evaluation of interdigital neuromas. J Foot Ankle Surg 36:364–366

    CAS  PubMed  Google Scholar 

  60. Thain LMF, Downey DB (2002) Sonography of peripheral nerves: technique, anatomy, and pathology. Ultrasound Quarterly 18:225–245

    PubMed  Google Scholar 

  61. Yang WT, Chui PT, Metreweli C (1998) Anatomy of the normal brachial plexus revealed by sonography and the role of sonographic guidance in anesthesia of the brachial plexus. AJR 171:1631–1636

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Martinoli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bacigalupo, L., Bianchi, S., Valle, M. et al. Ultraschall peripherer Nerven. Radiologe 43, 841–849 (2003). https://doi.org/10.1007/s00117-003-0963-y

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00117-003-0963-y

Schlüsselwörter

Keywords

Navigation