Abstract
Introduction
The aim of this study is to describe the normal cross-sectional area (CSA) and appearance of cervical nerve roots in ultrasound, correlating it to age and other patient somatic parameters.
Methods
One hundred healthy volunteers were included. We aimed to achieve uniform representation throughout all age groups. Ultrasound of the cervical nerve roots was performed bilaterally. CSA and margins description were obtained.
Results
C5 nerve, 8.32 ± 2.30; C6 nerve, 11.88 ± 3.36; C7 nerve, 12.79 ± 3.85; C8 nerve, 11.20 ± 3.45. Significant correlation between CSA and age was demonstrated, but not for body mass index. Blurred margins were present in up to 23.71% cervical nerves, more frequently in older individuals and in C7 nerve.
Discussion
If ultrasound morphology of cervical nerve roots is used as a diagnostic parameter, the normal range of CSA values and percentage of blurred margins according to age should be considered.
Similar content being viewed by others
Abbreviations
- US:
-
ultrasound
- CSA:
-
cross-sectional area
- GBS:
-
Guillain-Barré Syndrome
- BMI:
-
body mass index
References
Hobson-Webb LD, Padua L (2009) Median nerve ultrasonography in carpal tunnel syndrome: findings from two laboratories. Muscle Nerve 40:94–97
Zaidman CM, Seelig MJ, Baker JC, Mackinnon SE, Pestronk A (2013) Detection of peripheral nerve pathology: comparison of ultrasound and MRI. Neurology 80:1634–1640
Padua L, Di Pasquale A, Liotta G, Granata G, Pazzaglia C, Erra C et al (2013) Ultrasound as a useful tool in the diagnosis and management of traumatic nerve lesions. Clin Neurophysiol 124:1237–1243
Noto Y, Shiga K, Tsuji Y, Mizuta I, Higuchi Y, Hashiguchi A, Takashima H, Nakagawa M, Mizuno T (2015) Nerve ultrasound depicts peripheral nerve enlargement in patients with genetically distinct Charcot-Marie-Tooth disease. J Neurol Neurosurg Psychiatry 86:378–384
Kerasnoudis A, Pitarokoili K, Behrendt V, Gold R, Yoon MS (2015) Correlation of nerve ultrasound, electrophysiological and clinical findings in chronic inflammatory demyelinating polyneuropathy. J Neuroimaging 25:207–216
Matsuoka N, Kohriyama T, Ochi K, Nishitani M, Sueda Y, Mimori Y, Nakamura S, Matsumoto M (2004) Detection of cervical nerve root hypertrophy by ultrasonography in chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Sci 219:15–21
Gallardo E, Sedano MJ, Orizaola P, Sánchez-Juan P, González-Suárez A, García A, Terán-Villagrá N, Ruiz-Soto M, Álvaro RL, Berciano MT, Lafarga M, Berciano J (2015) Spinal nerve involvement in early Guillain-Barré syndrome: a clinico-electrophysiological, ultrasonographic and pathological study. Clin Neurophysiol 126:810–819
Jain S, Visser LH, Praveen TL, Rao PN, Surekha T, Ellanti R et al (2009) High-resolution sonography: a new technique to detect nerve damage in leprosy. PLoS Negl Trop Dis 3:e498
Grimm A, Décard BF, Schramm A, Pröbstel AK, Rasenack M, Axer H, Fuhr P (2016) Ultrasound and electrophysiologic findings in patients with Guillain-Barré syndrome at disease onset and over a period of six months. Clin Neurophysiol 127:1657–1663
Grimm A, Décard BF, Axer H (2014) Ultrasonography of the peripheral nervous system in the early stage of Guillain-Barré syndrome. J Peripher Nerv Syst 19:234–241
Takeuchi M, Wakao N, Hirasawa A, Murotani K, Kamiya M, Osuka K, Takayasu M (2017) Ultrasonography has a diagnostic value in the assessment of cervical radiculopathy: a prospective pilot study. Eur Radiol 27:3467–3473
Martinoli C, Bianchi S, Santacroce E, Pugliese F, Graif M, Derchi LE (2002) Brachial plexus sonography: a technique for assessing the root level. AJR Am J Roentgenol 179:699–702
Graif M, Martinoli C, Rochkind S, Blank A, Trejo L, Weiss J et al (2004) Sonographic evaluation of brachial plexus pathology. Eur Radiol 14:193–200
Haun DW, Cho JC, Kettner NW (2010) Normative cross-sectional area of the C5-C8 nerve roots using ultrasonography. Ultrasound Med Biol 36:1422–1430
Ulaşli AM, Tok F, Karaman A, Yaman F, Dikici O, Oruç S, Özçakar L (2014) Nerve enlargement after cold exposure: a pilot study with ultrasound imaging. Muscle Nerve 49:502–525
Won SJ, Kim BJ, Park KS, Kim SH, Yoon JS (2012) Measurement of cross-sectional area of cervical roots and brachial plexus trunks. Muscle Nerve 46:711–716
Takeuchi M, Wakao N, Kamiya M, Osuka K, Matsuo N, Terasawa T, Asai T, Takayasu M (2014) Morphological distinction of cervical nerve roots associated with motor function in 219 healthy volunteers: a multicenter prospective study. Spine (Phila Pa 1976) 39:E944–E949
Boehm J, Scheidl E, Bereczki D, Schelle T, Arányi Z (2014) High-resolution ultrasonography of peripheral nerves: measurements on 14 nerve segments in 56 healthy subjects and reliability assessments. Ultraschall Med 35:459–467
Pillen S, Semmekrot B, Meulstee J, Verrips A, Van Alfen N (2015) Ultrasound of the cervical roots and brachial plexus in neonates. Muscle Nerve 51:35–41
Lee SH, Chan VW, Lee JO, Kim HI (2011) Echotexture and correlated histologic analysis of peripheral nerves important in regional anesthesia. Reg Anesth Pain Med 36:382–386
Imagama S, Matsuyama Y, Yukawa Y, Kawakami N, Kamiya M, Kanemura T et al (2010) C5 palsy after cervical laminoplasty: a multicentre study. J Bone Joint Surg (Br) 92:393–400
Cartwright MS, Passmore LV, Yoon JS, Brown ME, Caress JB, Walker FO (2008) Cross-sectional area reference values for nerve ultrasonography. Muscle Nerve 37:566–571
Yoss RE, Corbin KB, Maccarty CS, Love JG (1957) Significance of symptoms and signs in localization of involved root in cervical disk protrusion. Neurology 7:673–683
Haymaker WE, Kernohan JW (1949) The Landry-Guillain-Barré syndrome; a clinicopathologic report of 50 fatal cases and a critique of the literature. Medicine (Baltimore) 28:59–141
Hafer-Macko CE, Sheikh KA, Li CY, Ho TW, Cornblath DR, McKhann GM et al (1996) Immune attack on the Schwann cell surface in acute inflammatory demyelinating polyneuropathy. Ann Neurol 39:625–635
Sugimoto T, Ochi K, Hosomi N, Mukai T, Ueno H, Takahashi T, Ohtsuki T, Kohriyama T, Matsumoto M (2013) Ultrasonographic reference sizes of the median and ulnar nerves and the cervical nerve roots in healthy Japanese adults. Ultrasound Med Biol 39:1560–1570
Padua L, Granata G, Sabatelli M, Inghilleri M, Lucchetta M, Luigetti M, Coraci D, Martinoli C, Briani C (2014) Heterogeneity of root and nerve ultrasound pattern in CIDP patients. Clin Neurophysiol 125:160–165
Klauser AS, Buzzegoli T, Taljanovic MS, Strobl S, Rauch S, Teh J, Wanschitz J, Löscher W, Martinoli C (2018) Nerve entrapment syndromes at the wrist and elbow by sonography. Semin Musculoskelet Radiol 22:344–353
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
The authors confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Drake-Pérez, M., Pelayo-Negro, A.L., Sánchez-de la Torre, J.R. et al. Ultrasonography of cervical nerve roots: cross-sectional reference values according to age. Neurol Sci 42, 215–223 (2021). https://doi.org/10.1007/s10072-020-04551-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-020-04551-x