Ultrasound imaging of nerves in the neck

Casaletto, Emily; Lin, Bin; Wolfe, Scott W.; Lee, Steve K.; Sneag, Darryl B.; Feinberg, Joseph H.; Nwawka, O. Kenechi

doi:10.1212/cpj.0000000000000767

Cited by 11 publications

(7 citation statements)

References 32 publications

(42 reference statements)

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“…While this study did not directly compare the efficacy of MRN versus US to detect nerve abnormalities, deeper coursing nerve segments, such as those of the axillary and long thoracic nerves, are typically more easily identified on MRN than US, assuming that motion artifacts do not degrade MR quality. However, the diagnostic performance of US for nerves located in the neck is overall high 25 …”

Section: Discussionmentioning

confidence: 99%

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Imaging of neuralgic amyotrophy in the acute phase

et al. 2022

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Introduction/Aims: Hourglass-like constrictions (HGCs) occur in neuralgic amyotrophy (NA), but the earliest time at which they can be recognized by imaging is poorly understood. We aimed to determine the prevalence of abnormal imaging findings in the acute phase of NA.Methods: Magnetic resonance neurography (MRN) and high-resolution ultrasound (US) examinations were performed at five sites. The investigation included 39 patients with acute NA who underwent imaging within 31 days of symptom onset. Correlation between imaging and electromyography (EMG) findings was measured.Results: US was performed in 29 patients and MRN in 23; 16 patients underwent US only, 10 MRN only, and 13 had both. US and MRN showed nerve abnormalities within 1 mo from NA onset in 90% of patients. HGCs were found in 74% (29/39) of the patients: 4 within 1 wk, 8 within 2 wk, 5 within 3 wk, and 12 within 4 wk. The earliest HGC on US was found within 12 h, and on MRN within 3 days from symptom onset. MRN demonstrated a denervation edema pattern of affected muscles in 91% of the patients. The shortest time to observe an edema pattern on MRN was 8 days. EMG was performed in 30 patients and revealed fibrillation potentials in affected muscles in 22 (73%). A denervation edema pattern on MRN was significantly associated with the presence of HGCs both on MRN and US, and with fibrillation potentials on EMG.Discussion: In the early phase of NA, US and MRN are useful diagnostic techniques for demonstrating nerve abnormalities.

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Section: Discussionmentioning

confidence: 99%

“…However, the diagnostic performance of US for nerves located in the neck is overall high. 25 Study limitations include its retrospective nature, the limited number of patients, and the fact that EMG was not considered mandatory to…”

Section: Discussionmentioning

confidence: 99%

Imaging of neuralgic amyotrophy in the acute phase

et al. 2022

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“…In addition, needle tips can be difficult to identify in ultrasound images 23 . The success of ultrasound imaging is also subject to operator skill and expertise 24 , 25 . Magnetic resonance imaging (MRI) is an alternative option to provide excellent soft tissue contrast and nearby anatomical landmarks with less dependence on operator performance 11 .…”

Section: Introductionmentioning

confidence: 99%

“… 23 The success of ultrasound imaging is also subject to operator skill and expertise. 24 , 25 Magnetic resonance imaging (MRI) is an alternative option to provide excellent soft tissue contrast and nearby anatomical landmarks with less dependence on operator performance. 11 However, MRI is expensive, time-consuming to implement, and unsafe to operate in the presence of ferromagnetic metallic devices or implants.…”

Section: Introductionmentioning

confidence: 99%

Optical absorption spectra and corresponding in vivo photoacoustic visualization of exposed peripheral nerves

Graham,

Sharma,

Padovano

et al. 2023

J. Biomed. Opt.

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Multispectral photoacoustic imaging has the potential to identify lipid-rich, myelinated nerve tissue in an interventional or surgical setting (e.g., to guide intraoperative decisions when exposing a nerve during reconstructive surgery by limiting operations to nerves needing repair, with no impact to healthy or regenerating nerves). Lipids have two optical absorption peaks within the NIR-II and NIR-III windows (i.e., 1000 to 1350 nm and 1550 to 1870 nm wavelength ranges, respectively) which can be exploited to obtain photoacoustic images. However, nerve visualization within the NIR-III window is more desirable due to higher lipid absorption peaks and a corresponding valley in the optical absorption of water.Aim: We present the first known optical absorption characterizations, photoacoustic spectral demonstrations, and histological validations to support in vivo photoacoustic nerve imaging in the NIR-III window.Approach: Four in vivo swine peripheral nerves were excised, and the optical absorption spectra of these fresh ex vivo nerves were characterized at wavelengths spanning 800 to 1880 nm, to provide the first known nerve optical absorbance spectra and to enable photoacoustic amplitude spectra characterization with the most optimal wavelength range. Prior to excision, the latter two of the four nerves were surrounded by aqueous, lipid-free, agarose blocks (i.e., 3% w/v agarose) to enhance acoustic coupling during in vivo multispectral photoacoustic imaging using the optimal NIR-III wavelengths (i.e., 1630 to 1850 nm) identified in the ex vivo studies.Results: There was a verified characteristic lipid absorption peak at 1725 nm for each ex vivo nerve. Results additionally suggest that the 1630 to 1850 nm wavelength range can successfully visualize and differentiate lipid-rich nerves from surrounding water-containing and lipid-deficient tissues and materials.Conclusions: Photoacoustic imaging using the optimal wavelengths identified and demonstrated for nerves holds promise for detection of myelination in exposed and isolated nerve tissue during a nerve repair surgery, with possible future implications for other surgeries and other optics-based technologies.

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“…Many of these are believed to be immune-mediated. [10][11][12][13] PN pathology can be diagnosed by ultrasound, electromyography, and fluoroscopy. Ultrasound is a repeatable, non-ionizing, noninvasive, and inexpensive imaging modality.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound imaging of the phrenic nerve at the scalene muscle level

Bedewi,

Habib,

Sifey

et al. 2023

Medicine

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The aim of this study is to utilize ultrasound to evaluate the normal cross-sectional area (CSA) of the phrenic nerve (PN), at the level of the anterior scalene muscle. The study included 62 PNs in 31 healthy subjects (13 men, 18 women); mean age, 36.6 years; mean height, 161.1 cm; mean weight, 69.6 kg; and mean body mass index 25.8 kg/m2. High-resolution ultrasound images of the bilateral PNs were obtained by a radiologist with 15 years of experience in neuromusculoskeletal ultrasound. Three separate CSA measurements for the bilateral PNs bilaterally were obtained. Images were also reviewed by an experienced neurologist to evaluate for inter-rater variability. The mean CSA of the right PN was 0.54 mm2 ± 0.16. The mean CSA of the left PN was 0.53 mm2 ± 0.18. We believe that the reference values for the normal CSA of the PNs obtained in our study could help in the sonographic evaluation of PN enlargement, as it relates to the diagnosis of various diseases affecting the PN. Furthermore, knowledge of its location and size, at the level of the scalene muscle, could help prevent PN-related complications during interventional procedures in that area. Additionally, for each participant, demographic information of age and gender as well as body mass index, weight, and height were documented.

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Ultrasound imaging of nerves in the neck

Cited by 11 publications

References 32 publications

Imaging of neuralgic amyotrophy in the acute phase

Imaging of neuralgic amyotrophy in the acute phase

Optical absorption spectra and corresponding in vivo photoacoustic visualization of exposed peripheral nerves

Ultrasound imaging of the phrenic nerve at the scalene muscle level

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