Learning objectives
Understanding the normal peripheral nervous anatomy conveyed by ultrasound.
Recognizing the importance of ultrasound in diagnosing many nervous pathological entities,
caused either by external compression,
trauma,
neoplasms,
infection or neuromuscular diseases.
Background
Ultrasound (US) is one of many imaging modalities forevaluating theperipheral nervous system.
Its increasing utility has made it an important aid to clinical and electrophysiological examinations.
Apart from being portable and cost-effective,
it also presents virtually no side effects or contraindications,
due to being a non-invasive and painless means of imaging.
The superficial course of nerves is one of the reasons why it is becoming increasingly popular among radiologists and other physicians,
allowing a dynamic approach to every morphological aspect of the anatomy,
as well...
Findings and procedure details
Equipment and technique
Currently,
the best assessment of peripheral nerves is achieved with high-frequency linear array probes (8-18 MHz),
using soft tissue software.
Array depth should be as minimal as possible and focal points should be directed to the nerve being studied.
A standard examination will start with axial visualization of the nerve,
followed by proximal and distal following,
finishing with a longitudinal scan,
most of the times at the area of pathology or entrapment.
Dynamic assessment should be performed whenever possible or indicated,
in...
Conclusion
The assessment of the peripheral nervous system can rely on ultrasound as its primary and first-approach modality of imaging.
Despite still not being a gold-standard imaging method for this purpose,
its non-invasive and dynamic characteristics establish it as a practical tool in diagnosing many peripheral neurologic disorders and pathologies.
Entrapment syndromes,
especially carpal tunnel syndrome and ulnar neuropathy,
peripheral nervous tumours and a growing application in the study of polyneuropathies are amongst the many areas where ultrasound can be of great help to any clinician.
References
Kopf,
H.,
et al.,
Diagnostic Sonography of Peripheral Nerves: Indications,
Examination Techniques and Pathological Findings, Diagnostische Sonografie peripherer… Ultraschall in Med 2011; 32: 242–266
Visser,
L.,
High resolution ultrasound in peripheral neuropathies (Teaching Course 5 / Advanced neurosonology - Level 3),
3rd Congress of the European Academy of Neurology,
Amsterdam,
June 24 – 27,
2017
Kele,
H.,
Ultrasonography of the peripheral nervous system,
New Trends in Neurosonology and Cerebral Hemodynamics — an Update,
perspectives in Medicine (2012) 1,
417—421
Kerasnoudis,
A.
and Tsivgoulis,
G.,
Nerve...