Role of ultrasound in evaluation of peripheral nerves

Abstract

Ultrasonography (USG) is an excellent cost-effective modality in imaging of peripheral nerves. With the newer high-frequency probes with different footprints which allow high-resolution imaging at relatively superficial location, USG can detect and evaluate traumatic, inflammatory, infective, neoplastic, and compressive pathologies of the peripheral nerves. This article describes the technique for evaluation of nerves by USG as well as the USG appearances of normal and diseased peripheral nerves.

Reference values for ultrasonograpy of peripheral nerves

“…More recently, high‐resolution ultrasound (HRU) has been used to evaluate peripheral nerves, particularly focal nerve entrapments and, increasingly, for evaluation of peripheral neuropathies . HRU is a low‐cost, quick, noninvasive imaging tool that provides morphological information about peripheral nerves and their surrounding tissues that is complementary to EDx studies, enabling integration of structural and physiologic information . Further, HRU images depict nerves with high image quality, which enables clinicians to examine long segments of peripheral nerves along their anatomical course while allowing dynamic imaging .…”

“…2 HRU is a low-cost, quick, noninvasive imaging tool that provides morphological information about peripheral nerves and their surrounding tissues that is comple-mentary to EDx studies, enabling integration of structural and physiologic information. [3][4][5] Further, HRU images depict nerves with high image quality, which enables clinicians to examine long segments of peripheral nerves along their anatomical course while allowing dynamic imaging. 6 Recent work has demonstrated that peripheral nerve ultrasonography is reliable and reproducible.…”

Ultrasonographic evaluation of the median nerve at the level of the carpal tunnel outlet and mid forearm in patients with type II Mucopolysaccharidosis

“…The US findings associated with the CTS have been described in adults and they consist of the increased size of the median nerve proximal to the flexors retinaculum, sudden change in size at the level of the tunnel outlet, decreased echogenicity, decreased mobility and increase of the Doppler signal [27,28]. According to the knowledge of the authors no studies regarding the US evaluation of the median nerve in MPS II patients have been published.…”

Nerve abscess in pure neural leprosy mistaken for peripheral nerve sheath tumour with disastrous consequence: what can we learn?

“…Nerves in leprosy are enlarged and exhibit structural abnormalities such as fusiform swelling, loss of fascicles, oedema and increased vascularity on sonography 10. Ultrasound imaging in a nerve abscess shows diffusely thickened nerve housing a hypoechoic cystic lesion with internal debris,2 whereas peripheral nerve sheath tumours appear as well-defined ovoid homogenous hypoechoic lesions with nerve entering and exiting from them 11. MRI may show diffuse oedema and swelling of the involved nerve due to neuritis.…”