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INTRODUCTION: Magnetic resonance neurography (MRN) and myography (MRM) are emerging imaging methods for detecting diseases of the peripheral nerve system (PNS). Most patients with PNS diseases also undergo needle electromyography (EMG). This study examined whether EMG led to lesions that were detectable using MRN/MRM and whether these lesions could impair image interpretation. METHODS: Ten patients who underwent clinically indicated EMG were recruited. MRN/MRM was performed before and 2-6 h after EMG, and if achievable, 2-3 days later. T2 signal intensity (SI) of the tibialis anterior muscle (TA) was quantified, and sizes and SI of the new lesions were measured. Visual rating was performed independently by three neuroradiologists. RESULTS: T2 lesions at the site of needle insertion, defined as focal edema, were detectable in 9/10 patients. The mean edema size was 31.72 mm2 (SD = 14.42 mm2 ) at the first follow-up. Susceptibility-weighted imaging lesions, defined as (micro) hematomas were detected in 5/10 patients (mean size, 23.85 mm2 [SD = 12.59 mm2 ]). General muscle SI of the TA did not differ between pre- and post-EMG examinations. Lesions size was relatively small, and the readers described image interpretation as not impaired by these lesions. DISCUSSION: This study showed that focal edema and hematomas frequently occurred after needle EMG and could be observed using MRN/MRM. As general muscle SI was not affected and image interpretation was not impaired, we concluded that needle EMG did not interfere with MRN/MRM.
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Enfermedades del Sistema Nervioso Periférico , Humanos , Electromiografía , Enfermedades del Sistema Nervioso Periférico/patología , Imagen por Resonancia Magnética/métodos , Miografía , Edema , HematomaRESUMEN
INTRODUCTION/AIMS: Concentric needle electromyography (CNEMG) is an essential examination for evaluating neuromuscular disorders, although pain is a drawback. Clustering Index (CI) method is a non-invasive quantitative analysis for surface electromyography (SEMG) that evaluates whether the signal area is clustered into the few large motor unit potentials (MUPs) or is evenly distributed. However, the diagnostic yield of the CI method in comparison with CNEMG is not known. In this study, we aimed to compare the sensitivity of the CI method with MUP parameters in CNEMG for diagnosing neurogenic or myogenic disorders. METHODS: We retrospectively identified patients for whom both SEMG and CNEMG were performed on the same tibialis anterior (TA) muscle. In CNEMG, seven MUP parameters were evaluated, including size index (SI) and revised size indices for neurogenic (rSIn) and myogenic (rSIm) disorders. RESULTS: Identified were 21 patients with neurogenic and 21 patients with myogenic disorders. Control data were constructed from 30 control subjects. The sensitivities of the CI method for the neurogenic and myogenic groups were 76% and 62%, respectively, which were not significantly different from MUP parameters, except for being significantly higher than those of amplitude and duration for myopathy (24%). Among MUP parameters, the sensitivities of rSIn (62%) and rSIm (57%) for myopathy were significantly higher than those of amplitude and duration. The CI method significantly correlated with the strength of the TA muscle in myopathy. DISCUSSION: The CI method, having comparable diagnostic yields to MUP parameters, is promising as a non-invasive diagnostic measure.
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Objective To analyze the nerve electrophysiological characteristics of stroke occurrence shoulder hand syndrome patients.Methods A total of 70 stroke patients hospitalized in the Department of Neurology of Ruian City Red Cross Hospital were selected.According to whether the occurrence of shoulder hand syndrome,the patients were defined as the observation group (32 cases) and the control group (38 cases).All patients during hospitalization received the median nerve needle electromyography and nerve conduction determination.The needle pole electromyo-gram examination results, sensory nerve action potential changes were observed and compared in the two groups. Results (1) After needle electromyography,all patients in the observation group showed abnormal potential ( such as fibrillation potentials was sharp waves).Among them,fibrillation potential observed in 2 cases(5.26%) in the control group,which was significantly lower than 21 cases (65.63%) in the observation group (χ2 =6.954,P=0.026).Positive sharp wave observed in 1 case(2.63%) in the control group,which was significantly lower than 11 cases (34.38%) in the observation group (χ2 =8.323, P =0.014 ) .Nerve conduction measurement results showed that the sensory nerve action potential amplitude of the observation group was significantly lower than that of the control group, and amplitude of sensory nerve in the observation group decreased more significantly than the control group.The average sensory nerve action potential of the observation group was (7.48 ±4.12) ms,which was significantly lower than (12.53 ±1.61)ms of the control group,amplitude of wave in the observation group decreased more significantly than the control group ( t =12.064, P =0.017 ) .Conclusion Shoulder hand syndrome nerve electrophysiological parameters changed significantly after stroke occurrence.Therefore,it can be used further for the early found brain after stroke shoulder hand syndrome and provide a theoretical basis.