Fascicular Ratio Pilot Study: High-Resolution Neurosonography—A Possible Tool for Quantitative Assessment of Traumatic Peripheral Nerve Lesions Before and After Nerve Surgery

Heinen, Christian; Dömer, Patrick; Schmidt, Thomas; Kewitz, Bettina; Janssen‐Bienhold, Ulrike; Kretschmer, Thomas

doi:10.1093/neuros/nyy355

Cited by 6 publications

(4 citation statements)

References 25 publications

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“…The calculation of the FR, CSR, VR, and MPR was carried out using the scientific image processing program Fiji 4 . The FR was measured as described 2 . In brief, B-mode neurosonographs (transverse view) were converted to 8-bit images, inverted, and the contrast enhanced using background subtraction.…”

Section: Methodsmentioning

confidence: 99%

“…In previous studies, a HRNS classification in accordance with the well-established Sunderland/Millesi criteria for nerve damage was developed 1 . Complementary, the so called fascicular ratio (FR) was introduced for quantification of nerve damage 2 , based on the findings of Tagliafico et al (2014) and Boom et al (2012). The FR allows for reliable differentiation between healthy and lesioned nerves.…”

Section: Introductionmentioning

confidence: 99%

“…The FR allows for reliable differentiation between healthy and lesioned nerves. Moreover, the FR of a recovering nerve significantly changed back from initial pathologic to physiological values associated with a clinical and/or electrophysiological reinnervation 2 . Unfortunately, FR cannot visualize the actual process of axonal regrowth.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative assessment of intraneural vascular alterations in peripheral nerve trauma using high-resolution neurosonography: technical note

Dömer

Janssen‐Bienhold

Kewitz

et al. 2021

Sci Rep

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High-resolution neurosonography (HRNS) has become a major imaging modality in assessment of peripheral nerve trauma in the recent years. However, the vascular changes of traumatic lesions have not been quantitatively assessed in HRNS. Here, we describe the vascular-ratio, a novel HRNS-based quantitative parameter for the assessment of intraneural vascular alterations in patients with nerve lesions. N = 9 patients suffering from peripheral nerve trauma were examined clinically, electrophysiologically and with HRNS (SonoSite Exporte, Fuji). Image analyses using Fiji included determination of the established fascicular ratio (FR), the cross-section ratio (CSR), and as an extension, the calculation of a vascular ratio (VR) of the healthy versus damaged nerve and a muscle perfusion ratio (MPR) in comparison to a healthy control group. The mean VR in the healthy part of the affected nerve (14.14%) differed significantly (p < 0.0001) from the damaged part (VR of 43.26%). This coincides with significant differences in the FR and CSR calculated for the damaged part versus the healthy part and the controls. In comparison, there was no difference between VRs determined for the healthy part of the affected nerve and the healthy controls (14.14% / 17.72%). However, the MPR of denervated muscles was significantly decreased compared to the non-affected contralateral controls. VR and MPR serve as additional tools in assessing peripheral nerve trauma. Image analysis and calculation are feasible. Combined with the more morphologic FR and CSR, the VR and MPR provide a more detailed insight into alterations accompanying nerve trauma.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quantitative assessment of intraneural vascular alterations in peripheral nerve trauma using high-resolution neurosonography: technical note

Dömer

Janssen‐Bienhold

Kewitz

et al. 2021

Sci Rep

Self Cite

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“…Fascicle density was also measured in this study with thoughts that it might be reduced in peripheral nerve disorders. In addition, this level of fascicular detail may be helpful in the management of traumatic peripheral nerve lesions …”

Section: Ultra‐high‐frequency Ultrasound Imagingmentioning

confidence: 99%

Emerging technologies in neuromuscular ultrasound

Hobson‐Webb

2020

Muscle and Nerve

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Neuromuscular ultrasound is an accepted and valuable element in the evaluation of peripheral nerve and muscle disease. However, ultrasound has several limitations to consider, including operator dependency and lack of a viable contrast agent. Fortunately, new technological advances show promise in resolving these issues. Ultrahigh resolution ultrasound enables imaging of the nerve at the fascicular level. Shear wave elastography imaging can provide measures of tissue stiffness that can act as a surrogate measure of nerve and muscle health. Photoacoustic imaging may overcome neuromuscular ultrasound's current lack of contrast agents to detect inflammation and other functional changes within nerve and muscle, while artificial intelligence stands to address operator dependency and improve diagnostic imaging. The basic principles of each of these technologies are discussed along with current research and potential future applications in neuromuscular imaging. K E Y W O R D S artificial intelligence, elastography, high resolution ultrasound, neuromuscular ultrasound, photoacoustic imaging

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Technological Advancements in Magnetic Resonance Neurography

Sneag

Queler

2019

Curr Neurol Neurosci Rep

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Fascicular Ratio Pilot Study: High-Resolution Neurosonography—A Possible Tool for Quantitative Assessment of Traumatic Peripheral Nerve Lesions Before and After Nerve Surgery

Cited by 6 publications

References 25 publications

Quantitative assessment of intraneural vascular alterations in peripheral nerve trauma using high-resolution neurosonography: technical note

Quantitative assessment of intraneural vascular alterations in peripheral nerve trauma using high-resolution neurosonography: technical note

Emerging technologies in neuromuscular ultrasound

Technological Advancements in Magnetic Resonance Neurography

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