Histopathology and high-resolution ultrasound imaging for peripheral nerve (injuries)

Ricci, Vincenzo; Ricci, Costantino; Cocco, Giulio; Gervasoni, Fabrizio; Donati, Danilo; Farì, Giacomo; Özçakar, Levent

doi:10.1007/s00415-022-10988-1

Cited by 38 publications

(45 citation statements)

References 36 publications

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“…As such, following the caudal-to-cranial tracking technique by shifting the probe back and forth could effectively clarify the C5 to T1 BP roots and recognize variations (14,30). Gentle tilting of the probe during the US scanning helped better delineate the edges of the nerve epineurium (31). The continuity of the BP root epineurium and fascicles and the existence of any accumulated cerebrospinal fluid or neuroma-like enlargement were recorded as observed (Supplementary Table 1).…”

Section: Methodsmentioning

confidence: 99%

Diagnostic performance of preoperative ultrasound for traumatic brachial plexus root injury: A comparison study with an electrophysiology study

Liu

Jia²,

Zhang³

et al. 2023

Front. Neurol.

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PurposeAccurate preoperative assessment for traumatic brachial plexus injury (BPI) is critical for clinicians to establish a treatment plan. The objective of this study was to investigate the diagnostic performance of preoperative ultrasound (US) through comparison with an electrophysiology study (EPS) in the assessment of traumatic brachial plexus (BP) root injury.Materials and methodsWe performed a retrospective study in patients with traumatic BPI who had preoperative US and EPS, excluding obstetric palsy and other nontraumatic neuropathies. US examination was performed on an EPIQ 5 color Doppler equipment. EPS was performed on a Keypoint 9033A07 Electromyograph/Evoked Potentials Equipment, testing electromyography (EMG), nerve conduction studies (NCS), and somatosensory evoked potentials (SEP). Each BP root of all patients was assessed by US and EPS as completely injured or incompletely injured, respectively. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated based on the correlation with intraoperative findings. The accuracy of US and EPS were compared using the McNemar test. The added benefit of US was evaluated by comparing the sensitivity and specificity between the combined tests with EPS using the McNemar test.ResultsThis study included 49 patients with traumatic BPI who underwent BP surgeries from October 2018 to September 2022. Surgical exploration confirmed 89 completely injured BP roots in 28 patients. US correctly detected 80 completely injured BP roots (sensitivity, 0.899; specificity, 0.981; PPV, 0.964; NPV, 0.944; accuracy, 0.951). EPS correctly detected 75 completely injured BP roots (sensitivity, 0.843; specificity, 0.929; PPV, 0.872; NPV, 0.912; accuracy, 0.898). US showed significantly higher accuracy than EPS (p = 0.03). When combining US and EPS for completely injured BP root detection, the sensitivity of the inclusive combination (0.966) was significantly higher than EPS alone (p = 0.000977), and the specificity of the exclusive combination (1.000) was significantly higher than EPS alone (p = 0.000977).ConclusionPreoperative US is an effective diagnostic tool in the assessment of traumatic BP root injury. US had higher accuracy than EPS in this study. Sensitivity and specificity were significantly higher than EPS when US was combined with EPS.

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Section: Methodsmentioning

confidence: 99%

Diagnostic performance of preoperative ultrasound for traumatic brachial plexus root injury: A comparison study with an electrophysiology study

Liu

Jia²,

Zhang³

et al. 2023

Front. Neurol.

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“…The vascular invasion at the site of the callus and its perfusion pattern can be precisely assessed, especially accurately setting the Doppler imaging to depict small vascular elements with slow blood flows (Fig. 5 ) [ 13 , 47 ].…”

Section: Ultrasound Assessment Of Fracture Healingmentioning

confidence: 99%

“…For instance, in non-displaced torus forearm fractures (i.e., Buckle fractures) and “greenstick” fractures, it has been shown that US is comparable to XR for both diagnosis and management [ 4 , 5 ]; moreover, several authors have demonstrated the pivotal role of US in the diagnosis of costal cartilage injuries in the pediatric population [ 2 , 6 , 7 ]. US is already widely used in musculoskeletal imaging for the assessment of superficial soft tissue illnesses [ 8 , 9 ], articular and periarticular pathologies [ 10 ], muscle disorders [ 11 , 12 ], nerve injuries [ 13 ], and tendinopathies [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound imaging of bone fractures

et al. 2022

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Ultrasound imaging is widely used to evaluate the neuromusculoskeletal system, and recently, a particular interest is mounting in assessing the bone tissue and fractures. Ultrasound can be considered a valuable diagnostic tool to perform a first-line evaluation of bone tissue, especially in particular settings without direct access to X-ray imaging and/or in emergency conditions. Moreover, different healing phases of bone fractures can be accurately assessed by combining the B-mode modality and (high-sensitive) color/power Doppler optimizing the management of patients—e.g., planning of progressive loads and rehabilitation procedures. In this review, we summarized the role of ultrasound imaging in the management of bone fractures and described the most common sonographic signs encountered in the daily practice by assessing different types of bone fractures and the progressive phases of the healing process.

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“…Second, and more important, a portion of the tibial nerve has been excluded from the region of interest in Figure 2(d), and only one of the two plantar nerves has been included in the CSA measurements in Figure 2(c) (Figure 1). Indeed, in the aforementioned figure (Figure 2), the tibial nerve is already divided into its distal branches acquiring a "bilobed shape" [2]. In order to avoid F I G U R E 1 Ultrasound imaging and cross-sectional area of peripheral nerves: a "matter of training".…”

Section: Hindsight For Ultrasound Imaging/measurement Of the Tibial N...mentioning

confidence: 99%

“…In Figure 2(c), the tibial nerve is divided into the medial and lateral plantar branches presenting a bilobed shape. In Figure 2 LETTER TO THE EDITOR possible misinterpretation of the sonographic appearance of peripheral nerves, we suggest (i) to tilt the ultrasound probe several times to take advantage of the anisotropy artifact [3] and better delineate the epineurium and (ii) to perform a wide sonographic tracking of the peripheral nerve to accurately visualize its "branching pattern", that is, also considering high anatomical variability among patients [2].…”

Section: Hindsight For Ultrasound Imaging/measurement Of the Tibial N...mentioning

confidence: 99%

Hindsight for ultrasound imaging/measurement of the tibial nerve

Ricci

Güvener

Özçakar

2022

Euro J of Neurology

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Histopathology and high-resolution ultrasound imaging for peripheral nerve (injuries)

Cited by 38 publications

References 36 publications

Diagnostic performance of preoperative ultrasound for traumatic brachial plexus root injury: A comparison study with an electrophysiology study

Diagnostic performance of preoperative ultrasound for traumatic brachial plexus root injury: A comparison study with an electrophysiology study

Ultrasound imaging of bone fractures

Hindsight for ultrasound imaging/measurement of the tibial nerve

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