High‐Resolution Nerve Ultrasound to Assess Nerve Echogenicity, Fascicular Count, and Cross‐Sectional Area Using Semiautomated Analysis

Abstract The purpose of this study was to compare the cross-sectional area (CSA) of joint visualization between extended interportal and T-capsulotomies. Twenty fresh-frozen cadaveric hips were dissected to their capsuloligamentous complexes and fixed in a custom apparatus in neutral hip position. Ten hips underwent sequential interportal capsulotomies at lengths of 2, 4, 6, and 8 cm. Ten hips underwent sequential T-capsulotomies starting from a 4 cm interportal capsulotomy, creating a 2 cm T-capsulotomy (Half-T), and finally a 4 cm T-capsulotomy (Full-T). Following each sequential capsule change in both groups, a high-resolution digital photograph was taken to measure the visualized intra-articular cross-sectional area (CSA). Independent t-test was used to compare CSA interportal and T-capsulotomy groups. Analysis demonstrated a statistically significant increase in CSA visualization with each sequential increase in interportal capsulotomy length up to 6 cm (2cm: 0.6 ± 0.2 cm2; 4cm: 2.1 ± 0.5 cm2 (p<0.001); 6cm: 3.6 ± 1.0 cm2 (p=0.001)), and no difference at 8cm (4.2 ± 1.2 cm2 (p=0.20)). For the T-capsulotomy group the average CSA visualization significantly increased from 3.2 ± 0.9 cm2 for the Half-T to 7.1 ± 1.0 cm2 for the Full-T (p<0.001). The Half-T CSA visualization was not statistically different from the 6 cm capsulotomy (p=0.4) and the 8cm capsulotomy (p=0.05). The Full-T had significantly superior CSA visualization area as compared to the 6 cm and 8 cm interportal capsulotomies (p<0.001 for both). In conclusion, T-capsulotomy resulted in improved cross-sectional area of joint visualization compared to an extended (8cm) interportal capsulotomy in a cadaveric model. Surgeons must weigh the benefits of greater visualization from T-capsulotomy that may help to avoid residual FAI while ensuring to completely repair the capsulotomy to avoid iatrogenic instability.

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Nerve ultrasound in the assessment of cross-sectional area in healthy children

Neuromuscular Diseases ◽

10.17650/2222-8721-2020-10-2-46-52 ◽

2020 ◽

Vol 10 (2) ◽

pp. 46-52

Author(s):

M. A. Bedova ◽

A. V. Klimkin ◽

V. B. Voitenkov ◽

N. V. Skripchenko

Keyword(s):

Cross Sectional Area ◽

Normative Values ◽

Technical Equipment ◽

Healthy Children ◽

Sectional Area ◽

Nerve Ultrasound ◽

Cross Sectional ◽

Group 13 ◽

The Cross ◽

Crosssectional Area

Introduction. Nerve ultrasound continues to progress due to improved technical equipment and knowledge, but so far not enough research has been done to determine the normative values of the cross-sectional area in children, and the obtained results differ between laboratories and researchers.Aim of the study. To determine the normative values of peripheral nerves» cross-sectional area in children 5–18 years old.Materials and methods. High resolution nerve ultrasound of brachial plexus, median, ulnar, radial, femoral, sciatic, tibial and peroneal nerves was performed in 30 children in real time. Nerve trunks were visualized throughout the limb from both sides. The cross-sectional area of the nerves was measured by a manual tracing method with the rounding of the hypoechogenic contours of the nerve trunk. Nerves’ crosssectional area was measured at distal and proximal sites. The obtained data were statistically processed using Excel and Statistica 10.Results. No bilateral cross-sectional area’s differences were found in children. Boys had significantly thicker nerves compared to girls, older age group (13–17 years old) compared to younger ones. There was a significant correlation between cross-sectional area of the median nerve at the level of the wrist, sciatic nerve and children’ height and weight.Conclusions. The normal values of cross-sectional area in children can be used in the practical work of a neurologists, neurophysiologists and ultrasound technicians.

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Reference values for the cross-sectional area of the vagus nerve in healthy subjects – preliminary results of a high-resolution ultrasound study

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0036-1587730 ◽

2016 ◽

Vol 37 (S 01) ◽

Author(s):

J Pelz ◽

E Belau ◽

D Weise

Keyword(s):

High Resolution ◽

Vagus Nerve ◽

Reference Values ◽

Healthy Subjects ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Preliminary Results ◽

Ultrasound Study ◽

The Cross

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Abstract 13796: Quantitative Measurement of Cross sectional Area of Small Pulmonary Vessels Using High-resolution Ct in Chronic Thromboembolic Pulmonary Hypertension

Circulation ◽

10.1161/circ.130.suppl_2.13796 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Toshihiko Sugiura ◽

Nobuhiro Tanabe ◽

Naoko Kawata ◽

Yukiko Matsuura ◽

Hajime Kasai ◽

...

Keyword(s):

Pulmonary Hypertension ◽

High Resolution ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Correlation Coefficients ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Pulmonary Vessels ◽

Lung Area ◽

Thromboembolic Pulmonary Hypertension

Background: It is generally recognized that there is narrowing and diminution of the small vessels on pulmonary angiography in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Previous studies have shown that these vascular alterations could be assessed by the cross-sectional area of small pulmonary vessels (CSA) on high-resolution CT (HRCT) in patients with COPD. However, it is unknown whether there is a correlation between CSA and hemodynamics in patients with CTEPH. Aims: We retrospectively evaluated the relationship between the CSA on HRCT and hemodynamics measured by right heart catheterization (RHC). Materials and Methods: 61 patients (61±12 yrs, 13 male) with proven CTEPH underwent non-enhanced 64-slice HRCT (Aquilion ONE, Toshiba) and RHC. The HRCT images with 0.5 mm section thickness and 10 mm spacing were selected from all of the CT images in each patient. Using a semiautomatic image-processing program (Image J), CSA less than 5mm2 and 5-10mm2 , and total lung area were measured, and the percentage of the total CSA less than 5mm2 and 5-10mm2 for the lung area (%CSA<5 and %CSA5-10, respectively) were calculated. The correlations of %CSA with hemodynamics measured by RHC were evaluated. Results: Mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) from RHC were 41±9 mmHg and 8.3±3.0 Wood Units, respectively. %CSA<5 and %CSA5-10 were 1.095±0.166% and 0.447±0.093 %, respectively. The correlation coefficients of %CSA<5 with mPAP and PVR were -0.45 (P<0.001) and -0.64 (P<0.001), respectively. The correlation coefficients of %CSA5-10 with mPAP and PVR were -0.20 (P=0.1) and -0.38 (P=0.002), respectively. Conclusions: This study suggests that %CSA<5 measured on HRCT is inversely correlated with PVR and can be used to evaluate hemodynamics in CTEPH subjects.

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High-resolution ultrasound in the assessment of peripheral nerves in leprosy: A comparative cross-sectional study

Indian Journal of Dermatology Venereology and Leprology ◽

10.25259/ijdvl_106_20 ◽

2021 ◽

Vol 0 ◽

pp. 1-8

Author(s):

Kalathummarath Sreejith ◽

Sarita Sasidharanpillai ◽

Kidangazhiathmana Ajithkumar ◽

Reeba Mary Mani ◽

Anuradha Thalian Chathoth ◽

...

Keyword(s):

High Resolution ◽

Peripheral Nerve ◽

Clinical Examination ◽

Peripheral Nerves ◽

Cross Sectional Area ◽

Nerve Function ◽

Sectional Area ◽

Cross Sectional ◽

Function Impairment ◽

The Cross

Background: Detection of peripheral nerve thickening and nerve function impairment is crucial in the diagnosis and the management of leprosy. Aims and objectives: (1) To document the cross-sectional area, echotexture and blood flow of peripheral nerves in healthy controls and leprosy cases using high-resolution ultrasound, (2) to compare the sensitivities of clinical examination and high-resolution ultrasound in detecting peripheral nerve thickening in leprosy. Methods: Peripheral nerves of 30 leprosy patients and 30 age- and sex-matched controls were evaluated clinically and by high-resolution ultrasound. When the cross-sectional area of a peripheral nerve on high-resolution ultrasound in a leprosy patient was more than the calculated upper bound of the 95% confidence interval for mean for that specific nerve in controls, that particular peripheral nerve was considered to be enlarged. Results: Cross-sectional areas more than 7.1 mm2 for the radial nerve, 8.17 mm2 for ulnar, 10.17 mm2 for median, 9.50 mm2 for lateral popliteal and 11.21mm2 for the posterior tibial nerve were considered as nerve thickening on high-resolution ultrasound. High-resolution ultrasound detected 141/300 (47%) nerves enlarged in contrast to the 60 (20%) diagnosed clinically by palpation (P < 0.001). Clinical examination identified thickening in 31/70 (44.3%) nerves in cases with impairment of nerve function and 29/230 (12.6%) in the absence of nerve function impairment. High-resolution ultrasound detected thickening in 50/70 (71.4%) nerves with impairment of function and in 91/230 (39.6%) nerves without any impairment of function. Limitation: A single-centre study design was the major study limitation. Conclusion: High-resolution ultrasound showed greater sensitivity than clinical examination in detecting peripheral nerve thickening in leprosy cases. High-resolution ultrasound, may therefore improve the sensitivity of the diagnostic criterion of peripheral nerve enlargement in the diagnosis and classification of leprosy.

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Role of High-Resolution Ultrasonography in Evaluation of Median Nerve and Thickness of Flexor Retinaculum in Patients with Hypothyroidism

Indian Journal of Musculoskeletal Radiology ◽

10.25259/ijmsr_45_2019 ◽

2020 ◽

Vol 2 ◽

pp. 36-43

Author(s):

Kunwar Pal Singh ◽

Kamlesh Gupta ◽

Iqbaljit Kaur ◽

Vijinder Arora

Keyword(s):

High Resolution ◽

Healthy Volunteers ◽

Median Nerve ◽

Cross Sectional Area ◽

Width Ratio ◽

Sectional Area ◽

Cross Sectional ◽

Flexor Retinaculum ◽

Nerve Fascicle ◽

High Resolution Ultrasonography

Objectives: To determine the role of high resolution ultrasonography in evaluation of cross sectional area, maximum nerve fascicle thickness and thickness/width ratio of the median nerve and flexor retinaculum thickness in patients with hypothyroidism and to correlate it with the healthy volunteers. Material and Methods: A prospective study was conducted from February 2018 to October 2019 on 62 patients which included 32 clinically proven cases of hypothyroidism and 30 healthy volunteers. High resolution ultrasonography was performed using high frequency linear probes. Results: The most affected parameter was cross sectional area of median nerve at three levels, inlet/outlet ratio of CSA of the median nerve and thickness of flexor retinaculum in hypothyroidism patients in correlation with healthy volunteers. These parameters showed statistically significant p values. Maximum nerve fascicle thickness and thickness/width ratio of the median nerve showed no statistical significance in hypothyroid patients in correlation with healthy volunteers. Conclusion: High-resolution ultrasonography plays an important role in evaluating the changes occuring in cross sectional area of the median nerve, its inlet/outlet CSA ratio and flexor retinaculum thickness in hypothyroidism patients as correlated with the healthy volunteers.

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4. Median/ulnar nerve ultrasound cross-sectional area ratio in ALS

Clinical Neurophysiology ◽

10.1016/j.clinph.2017.12.017 ◽

2018 ◽

Vol 129 (4) ◽

pp. e2

Author(s):

Jun Tsugawa ◽

Yu-ichi Noto ◽

Thanuja Dharmadasa ◽

Nidhi Garg ◽

Matthew C. Kiernan

Keyword(s):

Ulnar Nerve ◽

Area Ratio ◽

Cross Sectional Area ◽

Sectional Area ◽

Nerve Ultrasound ◽

Cross Sectional

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079 Nerve ultrasound cross sectional area does not correlate with electrodiagnostic carpal tunnel severity in the very elderly

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-anzan.78 ◽

2018 ◽

Vol 89 (6) ◽

pp. A32.2-A32

Author(s):

Eoin Mulroy ◽

Luciana Pelosi

Keyword(s):

Elderly Patients ◽

Median Nerve ◽

Carpal Tunnel ◽

Cross Sectional Area ◽

Age Group ◽

Sectional Area ◽

Very Elderly ◽

Nerve Ultrasound ◽

Cross Sectional ◽

Nerve Enlargement

IntroductionUltrasound measurement of median nerve cross-sectional area (CSA) at the wrist has emerged as an accurate and useful complement to electrophysiology in the diagnosis of carpal tunnel syndrome (CTS).AANEM, 2012 A number of studies have also shown a positive correlation between median nerve CSA and electrodiagnostic severity. After noting absence of the expected nerve enlargement on ultrasound in some very elderly patients, we sought to correlate nerve ultrasound and electrodiagnostic findings in a very elderly population and to compare this with a population of younger patients.MethodsWe undertook a retrospective review of electrophysiology and ultrasound data collected during routine clinical practice at our institution over a 13 month period. The correlation between electrodiagnostic severity and median nerve CSA at the wrist in patients aged 40–65 years (59 patients, 70 hands) was compared with a population of very elderly patients aged ≥80 years (33 patients, 40 hands). The sensitivity of nerve ultrasound for the detection of CTS was calculated for both groups.ResultsIn the 40–65 years age group, there was a strong positive correlation between electrodiagnostic severity and median nerve CSA (r=0.79, p<0.01). In patients aged over 80 years, there was no significant correlation between the two techniques (r=0.09, p=0.57). Compared to ‘gold standard’ electrophysiologic tests, nerve ultrasound sensitivity for the detection of CTS was 98% in the 40–65 years age group and 62% in the very elderly group.ConclusionThe absence of expected median nerve enlargement in very elderly patients with electrodiagnostic evidence of CTS may reflect a different pathophysiologic response to distal median nerve entrapment in advanced age. Our data also suggests that nerve CSA measurement alone may not be a reliable tool for the detection of CTS in the very elderly. Further studies of its diagnostic accuracy in very elderly patients are warranted.

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