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Role of nerve ultrasound versus electrophysiological studies in the evaluation of nerve injuries
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery Pub Date : 2020-03-05 , DOI: 10.1186/s41983-020-00166-3
Neveen Mohamed Elfayoumy , Hanan Helmy Elgendy , Marwa Saad Afify Saad , Amira A. Labib

Background High-resolution ultrasonography (US) is a non-invasive, readily applicable imaging modality capable of depicting real-time static and dynamic information concerning the peripheral nerves and their surrounding tissues. Although electrophysiological studies are the gold standard in the evaluation of nerve injuries, US can be used also to evaluate the morphological changes of nerve injuries. Objectives To evaluate the role of the high-resolution US in the assessment of nerve injuries and to compare it to the role of electrodiagnostic studies. Subjects and methods A total of 30 nerves from 22 consecutive patients with clinically definite nerve injury were considered. Two independent and blinded clinicians perform electrodiagnosis and US. The clinical, neurophysiological, and US findings were collected, and the contribution of US was then classified as “ contributive” or “non-contributive”, according to whether US confirmed the clinical and neurophysiological diagnosis or not. Results US was “contributive” (confirming the electrophysiological diagnosis) in 66.67% of cases ( n = 20), providing information about continuity of the nerve, morphological changes after injury as swelling, scar tissue formation, or neuroma formation with sensitivity of 75% compared to the electrodiagnostic studies and accuracy of 66.67%. Conclusion Ultrasound can be used, when available, as a complementary tool for electrodiagnostic studies to provide anatomical information about the injured nerves in case of complete axonal lesion.

中文翻译:

神经超声与电生理研究在神经损伤评估中的作用

背景 高分辨率超声 (US) 是一种非侵入性、易于应用的成像方式,能够描绘有关周围神经及其周围组织的实时静态和动态信息。虽然电生理研究是评估神经损伤的金标准,但超声也可用于评估神经损伤的形态变化。目的 评估高分辨率超声在神经损伤评估中的作用,并将其与电诊断研究的作用进行比较。受试者和方法 总共考虑了来自 22 名具有临床明确神经损伤的连续患者的 30 条神经。两名独立且不知情的临床医生进行电诊断和超声检查。收集了临床、神经生理学和超声检查结果,然后根据US是否证实临床和神经生理学诊断,将US的贡献分为“有贡献”或“无贡献”。结果 US 在 66.67% 的病例 (n = 20) 中“有贡献”(确认电生理诊断),提供有关神经连续性、损伤后形态变化(如肿胀、瘢痕组织形成或神经瘤形成)的信息,敏感性为 75%与电诊断研究相比,准确率为66.67%。结论 如果可用,超声可用作电诊断研究的补充工具,以在完全轴突病变的情况下提供有关受损神经的解剖学信息。结果 US 在 66.67% 的病例 (n = 20) 中“有贡献”(确认电生理诊断),提供有关神经连续性、损伤后形态变化(如肿胀、瘢痕组织形成或神经瘤形成)的信息,敏感性为 75%与电诊断研究相比,准确率为66.67%。结论 如果可用,超声可用作电诊断研究的补充工具,以在完全轴突病变的情况下提供有关受损神经的解剖学信息。结果 US 在 66.67% 的病例 (n = 20) 中“有贡献”(确认电生理诊断),提供有关神经连续性、损伤后形态变化(如肿胀、瘢痕组织形成或神经瘤形成)的信息,敏感性为 75%与电诊断研究相比,准确率为66.67%。结论 如果可用,超声可用作电诊断研究的补充工具,以在完全轴突病变的情况下提供有关受损神经的解剖学信息。或神经瘤形成与电诊断研究相比具有 75% 的敏感性和 66.67% 的准确性。结论 如果可用,超声可用作电诊断研究的补充工具,以在完全轴突病变的情况下提供有关受损神经的解剖学信息。或神经瘤形成与电诊断研究相比具有 75% 的敏感性和 66.67% 的准确性。结论 如果可用,超声可用作电诊断研究的补充工具,以在完全轴突病变的情况下提供有关受损神经的解剖学信息。
更新日期:2020-03-05
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