RESUMO
INTRODUCTION: High-resolution ultrasonography (HRU) is a novel method that provides morphological information about peripheral nerves. We aimed to determine reference values for nerve cross-sectional area (CSA) on HRU. METHODS: One hundred healthy volunteers had HRU of median, radial, ulnar, fibular, tibial, sural, and superficial fibular nerves at defined sites. The CSA was measured and the effects of age, gender, and body mass index (BMI) were evaluated. RESULTS: CSA values in healthy subjects are described. CSA is larger in lower limb motor nerves than in sensory nerves at similar sites, and the CSA tends to be symmetrical. The strongest effect on CSA was for age, although gender and BMI had some effects. CONCLUSIONS: This study provides normative values for HRU, and it suggests that further research with age- and gender-specific distributions must be a key priority in the development of HRU for use as a diagnostic test for peripheral nerve diseases.
Assuntos
Nervos Periféricos/diagnóstico por imagem , Nervos Periféricos/fisiologia , Ultrassonografia de Intervenção/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Condução Nervosa/fisiologia , Valores de Referência , Ultrassonografia de Intervenção/métodos , Adulto JovemRESUMO
Routine nerve conduction studies are normal in patients with small fiber neuropathy (SFN), and a definitive diagnosis is based on skin biopsy revealing reduced intra-epidermal nerve fiber density (IENFD). In large fiber polyneuropathy, ultrasound (US) parameters indicate enlargement in cross-sectional area (CSA). This study was aimed at determining if similar changes in large fibers on US are apparent in patients with SFN. Twenty-five patients with SFN diagnosed by reduced IENFD and 25 age- and body mass index (BMI)-matched healthy controls underwent US studies of sural and superficial peroneal sensory nerves. The mean CSA of the sural nerve in SFN patients was 3.2 ± 0.8 mm(2), and in controls, 2.7 ± 0.6 mm(2) (p < 0.0070), and this was independent of sex. There was no difference in the thickness-to-width ratio or echogenicity of the nerves. US of the sural nerve in patients diagnosed with small fiber neuropathy reveals an enlarged cross-sectional area similar to that in large fiber polyneuropathy.