Reference values for ultrasonograpy of peripheral nerves

Abstract

This study provides normative values for HRU, and it suggests that further research with age- and gender-specific distributions must be a key priority in the development of HRU for use as a diagnostic test for peripheral nerve diseases.

Electrodiagnostic and nerve ultrasonographic features in upper limb spasticity: an observational study

“…Table I shows the patients' clinical features. No NCS measure fell outside our normal range of values, which was in line with that reported by others (Puksa et al, 2003;Qrimli et al, 2016;Alber, 2017), at either affected or unaffected upper limbs (Table II). For the median nerve, affected vs unaffected upper limb comparisons showed significant differences in the APB DML (affected 3.9±0.5 ms vs unaffected 3.5±0.5 ms; p=0.047), CMAP amplitude (affected 12.1±2.2 mV vs unaffected 14.6±2.9 mV; p=0.013), F-wave minimal latency (affected 22.7±2.2 ms vs unaffected 25.3±3.2 ms; p=0.045) and nerve CSA at the elbow (affected 8.6±2.1 mm 2 vs unaffected 7.6±1.7 mm 2 ; p=0.045).…”

“…At variance, significant changes of the ulnar sensory nerve action potential and MNCV were found in the unaffected side of stroke patients, suggesting an increased risk of NCS abnormalities due to risk factors for polyneuropathy, such as diabetes mellitus (Paoloni et al, 2010). In our view, although none of the NCS measures recorded in this study in the two upper limbs fell outside the normal range values (Puksa et al, 2003;Qrimli et al, 2016;Alber, 2017), it is plausible that all the above-mentioned mechanisms, and in particular the "subclinical" involvement of the lower motor neuron in UMNS (Hara et al, 2000), might have contributed to the NCS asymmetries here detected. Furthermore, we also argue that spasticity might not have played a crucial role in the NCS differences observed between the upper limbs, given that we detected only a significant inverse correlation between wrist flexor MAS score and ulnar nerve ADM CMAP, and a significant direct correlation between finger flexor MAS score and ulnar nerve ADM DML.…”

High-resistance strength training does not affect nerve cross sectional area – An ultrasound study

“…This is in line with previous studies (Bathala et al, 2014, Qrimli et al, 2016), in which the median nerve in the forearm was found to be larger in men than women. On the contrary, one previous study (Kerasnoudis et al, 2013) reported no difference in CSA of the median nerve between men and women.…”

“…Moreover, the structure of peripheral nerves may be affected by trauma and tumors, and the cross sectional area (CSA) is often affected by disorders such as carpal tunnel syndrome/entrapment and neuropathies (Hobson-Webb and Padua, 2016). Several ultrasound studies have evaluated peripheral nerve morphology in arms and legs, contributing reference values and examining the relationship between CSA and factors such as height, weight, age and body mass index (BMI) (Cartwright et al, 2008, 2013, Kerasnoudis et al, 2013, Qrimli et al, 2016). …”

Sonographic Findings of Polyneuropathy Associated With Cerebrotendinous Xanthomatosis: A Case Report

“…On ultrasonographic examination, the CSA of the posterior tibial nerve was 150% to 220% greater than the normal reference value [89]. In addition, the CSAs of the other peripheral nerves were also significantly larger than the upper limits of the normal reference values [8910]. …”