Evaluation of peripheral nerve lesions with high-resolution ultrasonography and color Doppler.

PURPOSE: Traditionally, peripheral nerve lesions are diagnosed on the basis of clinical history, physical examination, and electrophysiological studies, and the role of imaging studies has been limited. The purpose of the study was to assess the usefulness of sonography in diagnosing peripheral nerve lesions. MATERIALS AND METHODS: Thirty adult patients with peripheral nerve lesion/s and 30 healthy adult volunteers were included in the study, and sonography of the relevant peripheral nerve/s was done. The mean cross-sectional area (CSA) of the involved nerves were compared using Student t-test. RESULTS: The study included patients with diabetic peripheral neuropathy (DPN), carpal tunnel syndrome, leprosy, peripheral nerve tumor, and peripheral nerve trauma. There was a significant increase in CSA of the median nerve and ulnar nerve in DPN patients, and of the median nerve within the carpal tunnel in carpal tunnel syndrome (P < 0.0001) as compared to age and sex-matched controls. Sonography showed significant thickening of both the ulnar and median nerves in patients with leprosy. On sonography, schwannoma and neurofibroma had a similar appearance and showed internal vascularity. In case of neural trauma, sonography allowed precise localization of the site and type of nerve injury. CONCLUSION: High-resolution sonography is useful in characterizing peripheral nerve lesions and can complement other diagnostic investigations such as the nerve conduction study. It is easily available and has the potential to become the first modality for the evaluation of focal peripheral nerve disorders.

Imaging spectrum of spinal dysraphism on magnetic resonance: A pictorial review.

Congenital malformations of spine and spinal cord are collectively termed as spinal dysraphism. It includes a heterogeneous group of anomalies which result from faulty closure of midline structures during development. Magnetic resonance imaging (MRI) is now considered the imaging modality of choice for diagnosing these conditions. The purpose of this article is to review the normal development of spinal cord and spine and reviewing the MRI features of spinal dysraphism. Although imaging of spinal dysraphism is complicated, a systematic approach and correlation between neuro-radiological, clinical and developmental data helps in making the correct diagnosis.