Shear wave elastography of the median nerve: A mechanical study

Abstract

Background: Shear wave elastography (SWE) shows promise in peripheral neuropathy evaluation but has potential limitations due to tissue size and heterogeneity. We tested SWE sensitivity to elasticity change and the effect of probe position in a median nerve cadaver model. Methods: Ten specimens were used to measure median nerve elasticity under increasing loads using SWE and indentation. Measurements were compared using repeated-measures analysis of variance. Results: Indentation and SWE-based longitudinal nerve elasticity increased with tensile loading (P < .01), showing a similar relationship. Acquisition in a transverse plane showed lower values compared with longitudinal measurements, mostly under higher loads (P = .03), as did postdissection elasticity (P = .02). Elasticity did not change when measured proximal to the carpal tunnel. Conclusions: Longitudinal SWE is sensitive to changes in median nerve elasticity. Measuring elasticity of peripheral nerves noninvasively could elucidate intra-neural pathology related to compression neuropathies, and proof to be of added value as a diagnostic or prognostic tool. K E Y W O R D S carpal tunnel syndrome, elastography, nerve elasticity, neurodynamics, peripheral neuropathy

Spatial variation in mechanical properties along the sciatic and tibial nerves: An ultrasound shear wave elastography study

“…Various animal models of peripheral neuropathies, such as those associated with metabolic syndrome (Layton et al, 2004), trauma (Zhu et al, 2020) or anti-neoplastic drugs (Bober and Shah, 2015), have shown that peripheral nerve stiffness tends to be higher regardless of etiology. Using ultrasound shear wave elastography, preliminary human studies have demonstrated that shear wave velocity of nerves, a surrogate measure of nerve stiffness (Schrier et al, 2020), increases in both compression (Kantarci et al, 2014) and diabetic (Dikici et al, 2016) neuropathies. However, these clinical investigations focused on a single nerve region and did not account for potential heterogeneity of mechanical changes along the course of peripheral nerves.…”

Preliminary study on the influencing factors of shear wave elastography for peripheral nerves in healthy population

“…Previous research reveals that diseases such as carpal tunnel syndrome and DPN can cause structural changes, edema within the nerve fascicle and reduction of blood flow, leading to the compression and increase in stiffness of the affected nerve 10,11 , which provide the possibility of diagnosis with SWE. At the same time, some studies have preliminarily confirmed that SWE can objectively reflect the increase of in stiffness of nerve tissue in indentation testing 12 . Yet, for such a new technology, there are relatively few studies on shear wave elastography of peripheral nerves, especially those addressing the methodology and influencing factors of peripheral nerve SWE in healthy people.…”

Effect of Perineural Injection with Different Dextrose Volumes on Median Nerve Size, Elasticity and Mobility in Hands with Carpal Tunnel Syndrome

“…A systemic review revealed the median nerve became stiffer after compression under shear wave elastography quantification [ 7 , 8 ]. Shear wave elastography had high sensitivity to detect changes in median nerve elasticity [ 9 ].…”