Peripheral nerve ultrasound: a survival guide for the practicing radiologist with updates
Keywords:
Nerve injury, Neuropathy, Neuro sonography, Neuroma, UltrasoundAbstract
Peripheral nerve injuries negatively impact patients’ quality of life and healthcare resources. This review discusses using high‑resolution neurosonography (HRNUS) for mapping peripheral nerves and detecting pathologic lesions. It emphasizes the importance of HRNUS in diagnosing nerve disorders and briefs the widely accepted schemes for peripheral nerve injury classification. It also highlights the non‑intrusive, flexible, patient‑friendly, and cost‑effective nature of HRNUS, making it a valuable tool in managing nerve disorders. The authors recommend the use of HRNUS to enable precise diagnoses, prevent permanent disabilities, and contribute to the efficient utilization of healthcare resources.
References
1. Huckhagel T, Nüchtern J, Regelsberger J, Lefering R, TraumaRegister DGU (2018) Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015. Scand J Trauma Resusc Emerg Med 26:76. https:// doi. org/ 10. 1186/ s13049‑ 018‑ 0546‑6
2. Huckhagel T, Nüchtern J, Regelsberger J, Gelderblom M, Lefering R, ® TraumaRegister DGU (2018) Nerve trauma of the lower extremity: evaluation of 60,422 leg injured patients from the TraumaRegister ®DGU between 2002 and 2015. Scand J Trauma Resusc Emerg Med 26:40. https:// doi. org/ 10. 1186/ s13049‑0 18‑0 502‑5
3. Padovano WM, Dengler J, Patterson MM, Yee A, Snyder‑Warwick AK, Wood MD, Moore AM, Mackinnon SE (2020) Incidence of nerve injury after extremity trauma in the United States. Hand. https:// doi. org/ 10. 1177/ 15589 44720 963895
4. Antoniadis G, Kretschmer T, Pedro MT, König RW, Heinen CPG, Richter H‑P (2014) Iatrogenic nerve injuries: prevalence, diagnosis and treatment. Dtsch Arztebl Int 111:273–279. https:// doi. org/ 10. 3238/ arzte bl. 2014. 0273
5. Chhabra A, Madhuranthakam AJ, Andreisek G (2018) Magnetic resonance neurography: current perspectives and literature review. Eur Radiol 28:698–707. https:// doi. org/ 10. 1007/ s00330‑0 17‑4 976‑8
6. Ku V, Cox C, Mikeska A, MacKay B (2021) Magnetic resonance neurography for evaluation of peripheral nerves. J Brachial Plex Peripher Nerve Inj 16:e17–e23. https:// doi. org/ 10. 1055/s‑0 041‑1 7291 76
7. Mallon S, Starcevic V, Rheinboldt M, Petraszko A (2018) Sonographic evaluation of peripheral nerve pathology in the emergency setting. Emerg Radiol 25:521–531. https:// doi. org/ 10. 1007/ s10140‑0 18‑1 611‑1
8. Nischal N, Gupta S, Lal K, Singh JP (2021) Performance evaluation of high‑resolution ultrasound versus magnetic resonance imaging in diagnosing peripheral nerve pathologies. Indian J Radiol Imaging 31:43–48. https:// doi. org/ 10. 1055/s‑0 041‑1 7291 30
9. Agarwal A, Chandra A, Jaipal U, Bagarhatta M, Mendiratta K, Goyal A, Kumar R, Mangalhara N (2019) Can imaging be the new yardstick for diagnosing peripheral neuropathy?—A comparison between high resolution ultrasound and MR neurography with an approach to diagnosis. Insights Imaging 10:104. https:// doi. org/ 10. 1186/ s13244‑0 19‑0 787‑6 10. Situ‑LaCasse EH, Amini R, Bain V, Acuña J, Samsel K, Weaver C, Valenzuela J, Pratt L, Patanwala AE, Adhikari S (2019) Performance of ultrasound‑guided peripheral nerve blocks by medical students after one‑day training session. Cureus. https:// doi. org/ 10. 7759/ cureus. 3911
11. Hobson‑Webb LD, Preston DC, Cartwright MS (2018) Neuromuscular ultrasound: a call for training and education. Muscle Nerve 57:168–169. https:// doi. org/ 10. 1002/ mus. 25989
12. Neubauer R, Recker F, Bauer CJ, Brossart P, Schäfer VS (2023) The current situation of musculoskeletal ultrasound education: a systematic literature review. Ultrasound Med Biol 49:1363–1374. https:// doi. org/ 10. 1016/j. ultra smedb io. 2023. 02. 008
13. Walsh PJ, Walter WR, Burke CJ, Adler RS, Beltran LS (2019) Percutaneous ultrasound‑guided intervention for upper extremity neural and perineural abnormalities: a retrospective review of 242 cases. Am J Roentgenol 212:W73–W82. https:// doi. org/ 10. 2214/ AJR. 18. 20047
14. Mathieu T, Lemmens E, Stassijns G (2022) A safe and easy‑to‑use ultrasound‑guided hydrodissection technique for the carpal tunnel syndrome: a minimally invasive approach. J Ultrasound 25:451–455. https:// doi. org/ 10. 1007/ s40477‑0 21‑0 0597‑5
15. Albano D, Aringhieri G, Messina C, De Flaviis L, Sconfienza LM (2020) High‑frequency and ultra‑high frequency ultrasound: musculoskeletal imaging up to 70 MHz. Semin Musculoskelet Radiol 24:125–134. https:// doi. org/ 10. 1055/s‑0 039‑3 40104 2
16. Meng S, Platzgummer H, Loizides A, Chang K‑V, Gruber H (2022) Ultrasound of small nerves. Ultraschall Med 43:12–33. https:// doi. org/ 10. 1055/a‑1 495‑5 294
17. Bönhof JA (2017) Ultrasound artifacts—part 2. Ultraschall Med 38:130–148. https:// doi. org/ 10. 1055/s‑0 043‑1 04216
18. Landau AJ, Parameswaran P, Fresco R, Simon L, Dy CJ, Brogan DM (2022) Systematic review of the use of power doppler ultrasound in the imaging of peripheral nerve compression neuropathy. Plast Reconstr Surg 149:48e–56e. https:// doi. org/ 10. 1097/ PRS. 00000 00000 008627
19. Smith S, Gandhi Mehta RK (2023) Ultrasound scanning protocol in the assessment of ulnar neuropathy at the elbow. J Vis Exp. https:// doi. org/ 10. 3791/ 65468
20. Bordalo M, de Paula F, Correa M, Yamashiro E (2023) High‑resolution ultrasound of the foot and ankle. Foot Ankle Clin 28:697–708. https:// doi. org/ 10. 1016/j. fcl. 2023. 04. 008
21. Abraham A, Fainmesser Y, Drory VE, Bril V (2023) Quantitative sonographic assessment of muscle thickness and fasciculations distribution is a sensitive tool for neuromuscular disorders. PLoS ONE 18:e0292123. https:// doi. org/ 10. 1371/ journ al. pone. 02921 23
22. Caillaud M, Richard L, Vallat J‑M, Desmoulière A, Billet F (2019) Peripheral nerve regeneration and intraneural revascularization. Neural Regen Res 14:24–33. https:// doi. org/ 10. 4103/ 1673‑ 5374. 243699
23. Klimovich P, Rubina K, Sysoeva V, Semina E (2021) New frontiers in peripheral nerve regeneration: concerns and remedies. Int J Mol Sci 22:13380. https:// doi. org/ 10. 3390/ ijms2 22413 380
24. Gordon T (2020) Peripheral nerve regeneration and muscle reinnervation. Int J Mol Sci 21:8652. https:// doi. org/ 10. 3390/ ijms2 12286 52
25. Chen B, Chen Q, Parkinson DB, Dun X (2019) Analysis of Schwann cell migration and axon regeneration following nerve injury in the sciatic nerve bridge. Front Mol Neurosci 12:308. https:// doi. org/ 10. 3389/ fnmol. 2019. 00308
26. Seddon HJ (1943) Three types of nerve injury. Brain 66:237–288. https:// doi. org/ 10. 1093/ brain/ 66.4. 237
27. Sunderland S (1951) A classification of peripheral nerve injuries producing loss of function. Brain 74:491–516. https:// doi. org/ 10. 1093/ brain/ 74.4. 491
28. Mackinnon SE, Dellon AL (1988) Surgery of the peripheral nerve, 1st edn. Thieme Medical Publishers, G. Thieme Verlag, New York
29. Jatoi M (2022) Role of sonography in assessment of upper extremity nerve pathologies: a literature review. J Med Imaging Radiat Sci 53:305–313. https:// doi. org/ 10. 1016/j. jmir. 2022. 01. 006
30. Tagliafico A, Martinoli C (2013) Reliability of side‑to‑side sonographic cross‑sectional area measurements of upper extremity nerves in healthy volunteers. J Ultrasound Med 32:457–462. https:// doi. org/ 10. 7863/ jum. 2013. 32.3. 457
31. Nitsch L, Kurzwelly D, Kornblum C, Pieper C, Clusmann H, Müller M (2020) High‑resolution ultrasound as a powerful diagnostic tool in peripheral nerve lesions: detection of an intraneural ganglion cyst in a patient with painful subacute peroneal nerve palsy. Ultraschall Med 41:77–79. https:// doi. org/ 10. 1055/a‑ 0990‑ 9989
32. Broekx S, Van Der Straeten R, D’Haen B, Vandevenne J, Ernon L, Weyns F (2021) Intraneural ganglion cyst of the common peroneal nerve causing foot drop in a 12‑year old child. Clin Neurol Neurosurg 209:106915. https:// doi. org/ 10. 1016/j. cline uro. 2021. 106915
33. Lee KH, Jeong YM, Jeon JY, Im T, Lee S‑W, Park SH, Kim JH (2018) Sonographic diagnosis of neuritis ossificans of the median nerve. J Clin Ultrasound 46:358–360. https:// doi. org/ 10. 1002/ jcu. 22544
34. Sammons M, Tami I, Giesen T (2021) Neuritis ossificans of the ulnar nerve at the elbow: a case report. J Hand Surg Eur 46:783–784. https:// doi. org/ 10. 1177/ 17531 93421 999777
35. O’Reilly MAR, O’Reilly PMR, Sheahan JN, Sullivan J, O’Reilly HM, O’Reilly MJ (2016) Neuromas as the cause of pain in the residual limbs of amputees. An ultrasound study. Clin Radiol 71:1068.e1‑1068.e6. https:// doi. org/ 10. 1016/j. crad. 2016. 05. 022
36. Endo Y, Sivakumaran T, Lee SC, Lin B, Fufa D (2021) Ultrasound features of traumatic digital nerve injuries of the hand with surgical confirmation. Skelet Radiol 50:1791–1800. https:// doi. org/ 10. 1007/ s00256‑ 021‑ 03731‑w
37. Coraci D, Pazzaglia C, Doneddu PE, Erra C, Paolasso I, Santilli V, Padua L (2015) Post‑traumatic neuroma due to closed nerve injury. Is recovery after peripheral nerve trauma related to ultrasonographic neuroma size? Clin Neurol Neurosurg 139:314–318. https:// doi. org/ 10. 1016/j. cline uro. 2015. 10. 034
38. Toia F, Gagliardo A, D’Arpa S, Gagliardo C, Gagliardo G, Cordova A (2016) Preoperative evaluation of peripheral nerve injuries: what is the place for ultrasound? J Neurosurg 125:603–614. https:// doi. org/ 10. 3171/ 2015.6. JNS15 1001
39. Chipman JN, Mott RT, Stanton CA, Cartwright MS (2009) Ultrasonographic Tinel sign. Muscle Nerve 40:1033–1035. https:// doi. org/ 10. 1002/ mus. 21461
40. Byra M, Wan L, Wong JH, Du J, Shah SB, Andre MP, Chang EY (2019) Quantitative ultrasound and B‑mode image texture features correlate with collagen and myelin content in human ulnar nerve fascicles. Ultrasound Med Biol 45:1830–1840. https:// doi. org/ 10. 1016/j. ultra smedb io. 2019. 02. 019
41. Heinen C, Dömer P, Schmidt T, Kewitz B, Janssen‑Bienhold U, Kretschmer T (2019) Fascicular ratio pilot study: high‑resolution neurosonography—a possible tool for quantitative assessment of traumatic peripheral nerve lesions before and after nerve surgery. Neurosurgery 85:415–422. https:// doi. org/ 10. 1093/ neuros/ nyy355
42. Gamber D, Motte J, Kerasnoudis A, Yoon M‑S, Gold R, Pitarokoili K, Fisse AL (2020) High‑resolution nerve ultrasound to assess nerve echogenicity, fascicular count, and cross‑sectional area using semiautomated analysis. J Neuroimaging 30:493–502. https:// doi. org/ 10. 1111/ jon. 12717
43. Byra M, Hentzen E, Du J, Andre M, Chang EY, Shah S (2020) Assessing the performance of morphologic and echogenic features in median nerve ultrasound for carpal tunnel syndrome diagnosis. J Ultrasound Med 39:1165–1174. https:// doi. org/ 10. 1002/ jum. 15201
44. Chang Y‑W, Hsieh T‑C, Tzeng I‑S, Chiu V, Huang P‑J, Horng Y‑S (2019) Ratio and difference of the cross‑sectional area of median nerve to ulnar nerve in diagnosing carpal tunnel syndrome: a case control study. BMC Med Imaging 19:52. https:// doi. org/ 10. 1186/ s12880‑0 19‑0 351‑3
45. Chang K‑V, Wu W‑T, Han D‑S, Özçakar L (2018) Ulnar nerve cross‑sectional area for the diagnosis of cubital tunnel syndrome: a meta‑analysis of ultrasonographic measurements. Arch Phys Med Rehabil 99:743–757. https:// doi. org/ 10. 1016/j. apmr. 2017. 08. 467
46. Kim JY, Song S, Park HJ, Rhee WI, Won SJ (2016) Diagnostic cutoff value for ultrasonography of the common fibular neuropathy at the fibular head. Ann Rehabil Med 40:1057–1063. https:// doi. org/ 10. 5535/ arm. 2016. 40.6. 1057
47. Kerasnoudis A, Ntasiou P, Ntasiou E (2017) Prognostic value of nerve ultrasound and electrophysiological findings in saturday night palsy. J Neuroimaging 27:428–432. https:// doi. org/ 10. 1111/ jon. 12414
48. Haj‑Mirzaian A, Hafezi‑Nejad N, Del Grande F, Endo Y, Nwawka OK, Miller TT, Carrino JA (2020) Optimal choice of ultrasound‑based measurements for the diagnosis of ulnar neuropathy at the elbow: a meta‑analysis of 1961 examinations. Am J Roentgenol 215:1171–1183. https:// doi. org/ 10. 2214/ AJR. 19. 22457
49. Hsieh P‑C, Chang K‑H, Wu Y‑R, Ro L‑S, Chu C‑C, Lyu R‑K, Liao M‑F, Kuo H‑C (2021) Cross‑sectional area reference values for sonography of peripheral nerves in Taiwanese adults. Front Neurol 12:722403. https:// doi. org/ 10. 3389/ fneur. 2021. 722403
50. Voltan G, Bernardes Filho F, Lugão HB, Nogueira‑Barbosa MH, Frade MAC (2022) Ultrasound reference values for peripheral nerve crosssectional areas and indices in a sample of healthy individuals in Brazil. Radiol Bras 55:337–345. https:// doi. org/ 10. 1590/ 0100‑3 984. 2022. 0020
51. Sindhu DM, Huddar A, Saini J, Vengalil S, Nashi S, Bardhan M, Unnikrishnan G, Rajula RR, Kandavel T, Bathala L, Visser LH, Nalini A (2022) Cross‑sectional area reference values of nerves in the upper and lower extremities using ultrasonography in the Indian population. Ann Indian Acad Neurol 25:449–456. https:// doi. org/ 10. 4103/ aian. aian_ 727_ 21
52. Pu S, Wu J, Han Q, Zhang X, Lv Y, Xu Y, Li C, Du D (2020) Ultrasonography‑guided radiofrequency ablation for painful stump neuromas to relieve postamputation pain: a pilot study. J Pain Res 13:3437–3445. https:// doi. org/ 10. 2147/ JPR. S2839 86
53. Härtig F, Ross M, Dammeier NM, Fedtke N, Heiling B, Axer H, Décard BF, Auffenberg E, Koch M, Rattay TW, Krumbholz M, Bornemann A, Lerche H, Winter N, Grimm A (2018) Nerve ultrasound predicts treatment response in chronic inflammatory demyelinating polyradiculoneuropathy—a prospective follow‑up. Neurotherapeutics 15:439–451. https:// doi. org/ 10. 1007/ s13311‑0 18‑0 609‑4
54. Pirri C, Stecco A, Fede C, De Caro R, Stecco C, Özçakar L (2020) Ultrasound imaging of a scar on the knee: sonopalpation for fascia and subcutaneous tissues. Eur J Transl Myol 30:8909. https:// doi. org/ 10. 4081/ ejtm. 2019. 8909
55. Gamil AM, Shalaby MH, Shehata KA, El Deeb AM (2020) Value of grayscale and power doppler high‑resolution ultrasound in assessment of patients with clinically suspected carpal tunnel syndrome. J Ultrasound Med 39:1155–1162. https:// doi. org/ 10. 1002/ jum. 15200
56. Murciano Casas MDLP, Rodríguez‑Piñero M, Jiménez Sarmiento A‑S, ÁlvarezLópez M, Jiménez Jurado G (2023) Evaluation of ultrasound as diagnostic tool in patients with clinical features suggestive of carpal tunnel syndrome in comparison to nerve conduction studies: study protocol for a diagnostic testing study. PLoS ONE 18:e0281221. https:// doi. org/ 10. 1371/ journ al. pone. 02812 21
57. Yildiran G, Seher N, Sutcu M, Nayman A, Akdag O, Tosun Z (2021) Median nerve’s microcirculation in carpal tunnel syndrome: superb microvascular imaging. Plast Reconstr Surg 147:1355–1360. https:// doi. org/ 10. 1097/ PRS. 00000 00000 007940
58. Deeg J, Mündel F, Loizides A, Gruber L, Gruber H (2023) Intraneural vascularity of the median, ulnar and common peroneal nerve: microvascular ultrasound and pathophysiological implications. Australas J Ultrasound Med 26:175–183. https:// doi. org/ 10. 1002/ ajum. 12334
59. Kutlar N, Bayrak AO, Bayrak İK, Canbaz S, Türker H (2017) Diagnosing carpal tunnel syndrome with Doppler ultrasonography: a comparison of ultrasonographic measurements and electrophysiological severity. Neurol Res 39:126–132. https:// doi. org/ 10. 1080/ 01616 412. 2016. 12754 55
60. Nageeb RS, Mohamed WS, Nageeb GS, Al Desoky E, Azmy TM (2019) Role of superficial peroneal sensory potential and high‑resolution ultrasonography in confirmation of common peroneal mononeuropathy at the fibular neck. Egypt J Neurol Psychiatry Neurosurg 55:23. https:// doi. org/ 10. 1186/ s41983‑ 019‑ 0060‑4
61. Chen L, Chen J, Hu B, Jiang L‑X (2017) Sonographic findings of the bifid median nerve and persistent median artery in carpal tunnel: a preliminary study in chinese individuals. Clinics 72:358–362. https:// doi. org/ 10. 6061/ clini cs/ 2017(06) 05
62. Onan B, Onan IS, Guner Y, Yeniterzi M (2014) Peroneal nerve palsy caused by popliteal pseudoaneurysm in a child with hereditary multiple exostosis. Ann Vasc Surg 28:1037.e5‑1037.e9. https:// doi. org/ 10. 1016/j. avsg. 2013. 08. 018
63. Prasetyo M, Rahardja RR, Yanuar A, Prihartono J, Setiawan SI (2021) Ultrasonography evaluation of the normal ulnar nerve in adult: comparison of the cross‑sectional area at elbow extension and flexion. Eur J Radiol Open 8:100331. https:// doi. org/ 10. 1016/j. ejro. 2021. 100331
64. Alshami AM, Alshammari TK, AlMuhaish MI, Hegazi TM, Tamal M, Abdulla FA (2022) Sciatic nerve excursion during neural mobilization with ankle movement using dynamic ultrasound imaging: a crosssectional study. J Ultrasound 25:241–249. https:// doi. org/ 10. 1007/ s40477‑ 021‑ 00595‑7
65. Ellis R, Richards N, Archer L, Whittington C, Mawston G (2021) Assessing sciatic nerve excursion and strain with ultrasound imaging during forward bending. Ultrasound Med Biol 47:2560–2569. https:// doi. org/ 10. 1016/j. ultra smedb io. 2021. 05. 018
66. Schertz M, Mutschler C, Masmejean E, Silvera J (2017) High‑resolution ultrasound in etiological evaluation of ulnar neuropathy at the elbow. Eur J Radiol 95:111–117. https:// doi. org/ 10. 1016/j. ejrad. 2017. 08. 003
67. Park G‑Y, Kwon DR, Seok JI, Park D‑S, Cho HK (2018) Usefulness of ultrasound assessment of median nerve mobility in carpal tunnel syndrome. Acta Radiol 59:1494–1499. https:// doi. org/ 10. 1177/ 02841 85118 762246
68. Gruber L, van Holsbeeck MT, Khoury V, Deml C, Gabl MF, Jaschke W, Klauser AS (2019) Compliance assessment and flip‑angle measurement of the median nerve: sonographic tools for carpal tunnel syndrome assessment? Eur Radiol 29:588–598. https:// doi. org/10. 1007/ s00330‑ 018‑ 5555‑3
69. Heiling B, Waschke A, Ceanga M, Grimm A, Witte OW, Axer H (2018) Not your average Saturday night palsy‑high resolution nerve ultrasound resolves rare cause of wrist drop. Clin Neurol Neurosurg 172:160–161. https:// doi. org/ 10. 1016/j. cline uro. 2018. 07. 006
70. Deng H, Lu B, Yin C, Xu Y, Ding Y, Mi Y, Xu P (2020) The effectiveness of ultrasonography in the diagnosis of spontaneous hourglasslike constriction of peripheral nerve in the upper extremity. World Neurosurg 134:e103–e111. https:// doi. org/ 10. 1016/j. wneu. 2019. 09. 111
71. Elshewi IE, Fatouh MM, Mohamed RNES, Basheer MA, El Liethy NE, Abbas HM (2022) Value of ultrasound assessment for traumatic nerve injury of the upper limb. J Ultrasound 26:409–421. https:// doi. org/ 10. 1007/ s40477‑ 022‑ 00756‑2
72. Cammarata MJ, Hill JB, Sharma S (2019) Ulnar nerve compression due to anconeus epitrochlearis: a case report and review of the literature. JBJS Case Connect 9:e0189. https:// doi. org/ 10. 2106/ JBJS. CC. 18. 00189
73. Pressney I, Upadhyay B, Dewlett S, Khoo M, Fotiadou A, Saifuddin A (2020) Accessory flexor carpi ulnaris: case report and review of the literature. BJR Case Rep 6:20200010. https:// doi. org/ 10. 1259/ bjrcr. 20200 010
74. Cesmebasi A, Spinner RJ, Smith J, Bannar SM, Finnoff JT (2016) Role of sonography in the diagnosis and treatment of common peroneal neuropathy secondary to fabellae. J Ultrasound Med 35:441–447. https:// doi. org/ 10. 7863/ ultra. 15. 04003
75. Della Vecchia G, Baldi A, Passavanti MB, Lucariello A, De Luca A, De Blasiis P (2023) Acute foot drop caused by intraneural ganglion cyst of the peroneal nerve: literature review and case report. J Personal Med 13:1137. https:// doi. org/ 10. 3390/ jpm13 071137
76. Salsamendi JT, Morffi D, Gortes FJ (2017) Removal of an intramuscular contraceptive implant. J Vasc Interv Radiol 28:465. https:// doi. org/ 10. 1016/j. jvir. 2016. 11. 010
77. Coraci D, Paolasso I, Santilli V, Padua L (2016) Extravascular heroin injection causing neuropathy: ultrasound picture. Neurol Sci 37:1887–1888. https:// doi. org/ 10. 1007/ s10072‑0 16‑2 651‑5
78. Coraci D, Tsukamoto H, Granata G, Briani C, Santilli V, Padua L (2015) Fibular nerve damage in knee dislocation: spectrum of ultrasound patterns. Muscle Nerve 51:859–863. https:// doi. org/ 10. 1002/ mus. 24472
79. Jacques T, Brienne C, Henry S, Baffet H, Giraudet G, Demondion X, Cotten A (2022) Minimally invasive removal of deep contraceptive implants under continuous ultrasound guidance is effective, quick, and safe. Eur Radiol 32:1718–1725. https:// doi. org/ 10. 1007/ s00330‑0 21‑0 8263‑4
80. Franchi MV, Raiteri BJ, Longo S, Sinha S, Narici MV, Csapo R (2018) Muscle architecture assessment: strengths, shortcomings and new frontiers of in vivo imaging techniques. Ultrasound Med Biol 44:2492–2504. https:// doi. org/ 10. 1016/j. ultra smedb io. 2018. 07. 010
81. Rajabkhah S, Moradi K, Okhovat AA, Van Alfen N, Fathi D, Aghaghazvini L, Ashraf‑Ganjouei A, Attarian S, Nafissi S, Fatehi F (2020) Application of muscle ultrasound for the evaluation of patients with amyotrophic lateral sclerosis: an observational cross‑sectional study. Muscle Nerve 62:516–521. https:// doi. org/ 10. 1002/ mus. 27036
82. Bignotti B, Ghio M, Panico N, Tagliafico G, Martinoli C, Tagliafico A (2015) High‑resolution ultrasound of peripheral nerves in systemic sclerosis: a pilot study of computer‑aided quantitative assessment of nerve density. Skelet Radiol 44:1761–1767. https:// doi. org/ 10. 1007/ s00256‑0 15‑2 230‑5
83. Borire AA, Visser LH, Padua L, Colebatch JG, Huynh W, Simon NG, Kiernan MC, Krishnan AV (2017) Utility of maximum perfusion intensity as an ultrasonographic marker of intraneural blood flow. Muscle Nerve 55:77–83. https:// doi. org/ 10. 1002/ mus. 25200
84. Zhu Y, Jin Z, Luo Y, Wang Y, Peng N, Peng J, Wang Y, Yu B, Lu C, Zhang S (2020) Evaluation of the crushed sciatic nerve and denervated muscle with multimodality ultrasound techniques: an animal study. Ultrasound Med Biol 46:377–392. https:// doi. org/ 10. 1016/j. ultra smedb io. 2019. 10. 004
85. Evans KD, Volz KR, Pargeon RL, Fout LT, Buford J, Roll SC (2014) Use of contrast‑enhanced sonography to investigate intraneural vascularity in a cohort of Macaca fascicularis with suspected median mononeuropathy. J Ultrasound Med 33:103–109. https:// doi. org/ 10. 7863/ ultra. 33.1. 103
86. Lee J, Lee D, Suh G‑H, Choi J (2023) Contrast‑enhanced ultrasonography for evaluation of the blood perfusion of sciatic nerves in healthy dogs. Vet Radiol Ultrasound 64:322–329. https:// doi. org/ 10. 1111/ vru. 13180
87. Volz KR, Evans KD, Kanner CD, Dickerson JA (2016) Detection of intraneural median nerve microvascularity using contrast‑enhanced sonography: a pilot study. J Ultrasound Med 35:1309–1316. https:// doi. org/ 10. 7863/ ultra. 15. 07012
88. Motomiya M, Funakoshi T, Ishizaka K, Nishida M, Matsui Y, Iwasaki N (2018) Blood flow changes in subsynovial connective tissue on contrast‑enhanced ultrasonography in patients with carpal tunnel syndrome before and after surgical decompression. J Ultrasound Med 37:1597–1604. https:// doi. org/ 10. 1002/ jum. 14500
89. Song P, Rubin JM, Lowerison MR (2023) Super‑resolution ultrasound microvascular imaging: is it ready for clinical use? Z Med Phys 33:309–323. https:// doi. org/ 10. 1016/j. zemedi. 2023. 04. 001
90. Andersen SB, Sørensen CM, Jensen JA, Nielsen MB (2022) Microvascular imaging with super‑resolution ultrasound. Ultraschall Med 43:543–547. https:// doi. org/ 10. 1055/a‑1 937‑6 868
91. Zhang J, Zhu W, Lin M, Jiang C (2021) Superb microvascular imaging for detecting carpal tunnel syndrome compared with power Doppler ultrasonography: a protocol for systematic review and meta‑analysis. Medicine 100:e24575. https:// doi. org/ 10. 1097/ MD. 00000 00000 024575
92. Lin T‑Y, Shen P‑C, Chang K‑V, Wu W‑T, Özçakar L (2024) Assessment of the carpal tunnel and associated neural structures with superb microvascular imaging: a scoping review. Expert Rev Med Devices 21:141–147. https:// doi. org/ 10. 1080/ 17434 440. 2023. 22858 56
93. Sigrist RMS, Liau J, Kaffas AE, Chammas MC, Willmann JK (2017) Ultrasound elastography: review of techniques and clinical applications. Theranostics 7:1303–1329. https:// doi. org/ 10. 7150/ thno. 18650
94. Cornelson SM, Ruff AN, Wells C, Sclocco R, Kettner NW (2022) Sonographic measures and sensory threshold of the normal sciatic nerve and hamstring muscles. J Ultrasound 25:47–57. https:// doi. org/ 10. 1007/ s40477‑ 020‑ 00552‑w
95. Shang S, Yan W, Guo Y, Guo H, Chen R, Cong S, Huang C (2023) The normal value and influencing factors of shear wave elastography in healthy tibial nerves: a cross‑sectional study. Health Sci Rep 6:e1412. https:// doi. org/ 10. 1002/ hsr2. 1412
96. Chen R, Wang X‑L, Xue W‑L, Sun J‑W, Dong X‑Y, Jiang Z‑P, Wu H, Ma R, Zhou X‑L (2020) Application value of conventional ultrasound and real‑time shear wave elastography in patients with type 2 diabetic polyneuropathy. Eur J Radiol 126:108965. https:// doi. org/ 10. 1016/j. ejrad. 2020. 108965
97. Pradhan DR, Saxena S, Kant R, Kumar M, Saran S (2024) Shear wave elastography of tibial nerve in patients with diabetic peripheral neuropathy—a cross‑sectional study. Skelet Radiol 53:547–554. https:// doi. org/ 10. 1007/ s00256‑ 023‑ 04448‑8
98. Sernik RA, Pereira RFB, Cerri GG, Damasceno RS, Bastos BB, Leão RV (2023) Shear wave elastography is a valuable tool for diagnosing and grading carpal tunnel syndrome. Skelet Radiol 52:67–72. https:// doi. org/ 10. 1007/ s00256‑ 022‑ 04143‑0
99. Kim S, Lee GY (2021) Evaluation of the ulnar nerve with shear‑wave elastography: a potential sonographic method for the diagnosis of ulnar neuropathy. Ultrasonography 40:349–356. https:// doi. org/ 10. 14366/ usg. 20101
100. Huang D, Meng L, Jiang L, Wang Z, Chen L, Yuan Y (2023) Evaluation of the median nerve by shear wave elastography in patients with CharcotMarie‑Tooth disease type 1A. Med Ultrason 25:161–167. https:// doi. org/ 10. 11152/ mu‑ 3938
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Mohamed Ragab Nouh, Hoda Mohamed Abdel‑Naby, Tarek El Sakka, Mohamed El-Shafei (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
