Diagnostische Sonografie peripherer Nerven: Indikationen, Techniken und Pathologien

Kopf, H; Loizides, Alexander; Mostbeck, G.; Gruber, Hannes

doi:10.1055/s-0031-1273309

Cited by 38 publications

(21 citation statements)

References 30 publications

(87 reference statements)

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“…It is also noteworthy that high-resolution nerve ultrasound may visualize nerve compromise related to motion with less effort than MRN. The basic requirement for this method, that is already frequently used for the examination of the PNS, is a high-end sonography unit provided with a highresolution broadband linear probe (> 12 MHz, ideally 18-22 MHz) and corresponding soft tissue contrast enhancing software [23]. With a 15 MHz transmission frequency, an axial resolution of up to 250 µm can be achieved [23].…”

Section: Carpal Tunnel Syndromementioning

confidence: 99%

“…The basic requirement for this method, that is already frequently used for the examination of the PNS, is a high-end sonography unit provided with a highresolution broadband linear probe (> 12 MHz, ideally 18-22 MHz) and corresponding soft tissue contrast enhancing software [23]. With a 15 MHz transmission frequency, an axial resolution of up to 250 µm can be achieved [23]. The axial in-plane resolution of MRN at distal extremity level is at a similar order at 100-200 µm and depends on several factors such as acquisition time.…”

Section: Carpal Tunnel Syndromementioning

confidence: 99%

“…Besides cost-and time-effectiveness, the major advantage of high-resolution sonography is that it allows direct and dynamic imaging of peripheral nerves under physiological movement. It might be helpful for example in secondary or atypical cubital tunnel syndrome, where it can help to establish the diagnosis of ulnar nerve dislocation over the medial epicondyle, which typically occurs during elbow flexion and is reduced with elbow extension, and at the same time to clarify whether additional snapping triceps syndrome accompanies this pathological situation [23,24].…”

Section: Carpal Tunnel Syndromementioning

confidence: 99%

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MR Neurography: Diagnostic Imaging in the PNS

2015

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The diagnostic work-up of peripheral neuropathies is often challenging and is mainly based on a combination of clinical and electrophysiological examinations. One of the most important difficulties is the accurate determination of the lesion site (lesion localization), lesion extension, and spatial lesion dispersion, which all represent essential diagnostic information crucial for finding the correct diagnosis and hence an adequate therapeutic approach. A typical pitfall in the conventional diagnostic reasoning is the differentiation between a distal, complete cross-sectional nerve lesion and a more proximally located, fascicular nerve lesion. Magnetic resonance neurography (MRN) has been proven to be capable of improving the diagnostic accuracy by providing direct, noninvasive visualization of nerve injury with high structural resolution even reaching the anatomical level of single nerve fascicles (fascicular imaging) and at the same time with large anatomical coverage. It is also feasible to detect structural nerve damage earlier and with higher sensitivity than gold-standard nerve conduction studies. The purpose of this study is to review the literature for current developments and advances in MRN for the precise spatial detection of nerve lesions in focal and non-focal disorders of the peripheral nervous system.

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Section: Carpal Tunnel Syndromementioning

confidence: 99%

Section: Carpal Tunnel Syndromementioning

confidence: 99%

Section: Carpal Tunnel Syndromementioning

confidence: 99%

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MR Neurography: Diagnostic Imaging in the PNS

2015

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“…In the distal direction the participation of sheaths and the number of bundles increases. The most significant quantitative parameter assessed in the examination is the cross-sectional area (CsA) [5]. This area is contained in a borderline between hypoechogenic bundles and hyperechogenic epineurium, which is usually clearly visible.…”

Section: Technical Requirements and Proper Ultrasound Imaging Of The mentioning

confidence: 99%

Methodology and indications for high-resolution sonography (HRUS) of the nerves

Böhm¹

2015

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A -study Design, B -Data Collection, C -statistical Analysis, D -Data Interpretation, E -manuscript Preparation, F -Literature search, G -funds Collection Imaging-techniques of the peripheral nervous system such as high-resolution ultrasonography (hRUs) and mR--neurography are increasingly utilized worldwide for the investigation of peripheral nerve disorders. Both methods provide important informations about the morphology of the peripheral nerves, nerve-roots and the brachial plexus. The low cost in comparison with mR-neurography, possibility of a dynamic examination, assessing long nerves segments in a short time, bedside-availability, non-invasivity and the possibility of Us-guided nerves blocks and therapies make hRUs the ideal imaging tool in peripheral nerve diseases. hRUs allows the detection of alterations even in single fascicles and the perineurium and provides important additional information on morphological aspects and etiology of peripheral nerve pathology. It allows a precise localisation of the nerve lesion and provides information about the underlying etiology. hRUs is especially useful in detecting structural abnormalities of the nerves caused by compression, trauma, tumor, inflammation and a variety of non-neoplastic conditions, including nerve torsion. hRUs can be helpful in operation planning, intraoperative management and in detecting the causes of failed operations. This review presents an overview about the most relevant neurological applications of hRUs taking into account the personal experiences of the author. Key words: high-resolution ultrasound, peripheral nerve entrapment-syndrome, injuries of the peripheral nerves, tumors of the peripheral nerve sheath, polyneuropathy, nerve torsion.Techniki obrazowe, jak wysokorozdzielcza ultrasonografia (high-resolution ultrasonography, hRUs) oraz neurografia rezonansu magnetycznego, znajdują coraz szersze zastosowanie w diagnostyce chorób obwodowego układu nerwowego. obie metody dostarczają istotnych informacji o morfologii nerwów obwodowych, korzeni rdzeniowych oraz splotu barkowego. Zalety hRUs, czyniące z tej metody idealne narzędzie do obrazowania nerwów obwodowych, to: niski koszt (w porównaniu z neurografią rezonansu magnetycznego), dynamiczna ocena morfologiczna, możliwość oceny długich odcinków nerwów w krótkim czasie, możliwość diagnostyki przy łóżku pacjenta, nieinwazyjność oraz możliwość nawigacji przy blokadach i innych zabiegach. W obecnym stopniu zaawansowania technologicznego hRUs pozwala wykryć zmiany nawet w pojedynczych włóknach nerwowych, w onerwiu i w nanerwiu oraz przynosi istotną, dodatkową informację o zmianach morfologicznych i etiologii chorób nerwów obwodowych. hRUs umożliwia ponadto precyzyjną lokalizację uszkodzenia nerwu i dostarcza informacji o jego etiologii. szczególną przydatność metoda wykazuje w wykrywaniu strukturalnych zmian, powodowanych przez ucisk, jak w zespole cieśni nadgarstka oraz w uszkodzeniu nerwu łokciowego w rowku, przez uraz, guz, zapalenie oraz innego typu uszkodzenia jak skręcenie. metoda pom...

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“…This can be lessened by a detailed pre-operative ultrasound examination and a careful operation or intervention with a full understanding of the ultrasound anatomy and pathology of the peripheral nerves (Kopf et al 2011 ). Unusual features of the nerves may be noted during the venous examination which can lead to an alternative diagnosis of leg discomfort.…”

Section: Peripheral Nerves In Relation To Leg Veinsmentioning

confidence: 99%