Angela Puma1,2, N Azulay3, N Grecu4, C Suply4, E Panicucci4, C Cambieri4,5, L Villa4,6, C Raffaelli3, S Sacconi4,7. 1. Peripheral Nervous System, Muscle and ALS Department, CHU Nice, Université Côte D'Azur, Nice, France. puma.ar@chu-nice.fr. 2. UMR7370 CNRS, LP2M, Labex ICST, Faculty of Medicine, Université Nice Côte d'Azur, Nice, France. puma.ar@chu-nice.fr. 3. Ultrasound Department, CHU Nice, Université Côte d'Azur, Nice, France. 4. Peripheral Nervous System, Muscle and ALS Department, CHU Nice, Université Côte D'Azur, Nice, France. 5. Department of Human Neuroscience, Centre of Rare Neuromuscular Diseases, Sapienza University of Rome, Rome, Italy. 6. Pathology Department, CHU Nice, Université Côte d'Azur, Nice, France. 7. Institute for Research on Cancer and Aging of Nice (IRCAN), INSERM U1081, CNRS UMR 7284, Faculty of Medicine, Université Côte d'Azur (UCA), Nice, France.
Abstract
OBJECTIVES: High-frequency ultrasound (HFUS 18-20 MHz) performed on patients with chronic inflammatory demyelinating polyneuropathy (CIDP) shows a focal enlargement, particularly in the proximal segments of upper-arm motor nerves. Ultrahigh frequency ultrasound (UHFUS 30-70 MHz), having a higher spatial resolution, enables a better characterization of nerve structures. The aim of this study was to compare the two ultrasound probes in the evaluation of motor nerve characteristics in CIDP patients. METHODS: Eleven patients with definite or probable CIDP underwent an ultrasound evaluation of median and ulnar nerves, bilaterally. Nerve and fascicle cross-sectional area (CSA), vascularization, and echogenicity were assessed. RESULTS: Nerve and fascicle CSA were increased in the proximal segments, especially in the median nerve, in 9/11 patients and in 10/11 patients at the HFUS and UHFUS evaluations, respectively. A statistically significant difference between CSA values obtained with the two probes was found only for fascicle values. UHFUS allowed for a more precise estimation of fascicle size and number than the HFUS. We were able to identify nerve vascularization in 4/11 patients at UHFUS only. CONCLUSION: UHFUS gives more detailed information on the changes in the internal nerve structure in CIDP patients. In particular, it permits to better characterize fascicle size and morphology, and to have a precise estimation of their number. Its frequency range also allows to evaluate nerve vascularization. SIGNIFICANCE: Ultrasound evaluation could become an adjunctive diagnostic tool for CIDP. Further studies are needed to validate the examined parameters as biomarkers for the evaluation and follow-up of CIDP patients.
OBJECTIVES: High-frequency ultrasound (HFUS 18-20 MHz) performed on patients with chronic inflammatory demyelinating polyneuropathy (CIDP) shows a focal enlargement, particularly in the proximal segments of upper-arm motor nerves. Ultrahigh frequency ultrasound (UHFUS 30-70 MHz), having a higher spatial resolution, enables a better characterization of nerve structures. The aim of this study was to compare the two ultrasound probes in the evaluation of motor nerve characteristics in CIDPpatients. METHODS: Eleven patients with definite or probable CIDP underwent an ultrasound evaluation of median and ulnar nerves, bilaterally. Nerve and fascicle cross-sectional area (CSA), vascularization, and echogenicity were assessed. RESULTS: Nerve and fascicle CSA were increased in the proximal segments, especially in the median nerve, in 9/11 patients and in 10/11 patients at the HFUS and UHFUS evaluations, respectively. A statistically significant difference between CSA values obtained with the two probes was found only for fascicle values. UHFUS allowed for a more precise estimation of fascicle size and number than the HFUS. We were able to identify nerve vascularization in 4/11 patients at UHFUS only. CONCLUSION: UHFUS gives more detailed information on the changes in the internal nerve structure in CIDPpatients. In particular, it permits to better characterize fascicle size and morphology, and to have a precise estimation of their number. Its frequency range also allows to evaluate nerve vascularization. SIGNIFICANCE: Ultrasound evaluation could become an adjunctive diagnostic tool for CIDP. Further studies are needed to validate the examined parameters as biomarkers for the evaluation and follow-up of CIDPpatients.
Authors: P Y K Van den Bergh; R D M Hadden; P Bouche; D R Cornblath; A Hahn; I Illa; C L Koski; J-M Léger; E Nobile-Orazio; J Pollard; C Sommer; P A van Doorn; I N van Schaik Journal: Eur J Neurol Date: 2010-03 Impact factor: 6.089
Authors: L Padua; G Granata; M Sabatelli; M Inghilleri; M Lucchetta; M Luigetti; D Coraci; C Martinoli; C Briani Journal: Clin Neurophysiol Date: 2013-10-05 Impact factor: 3.708
Authors: H S Goedee; G J F Brekelmans; J T H van Asseldonk; R Beekman; W H Mess; L H Visser Journal: Eur J Neurol Date: 2013-05-23 Impact factor: 6.089