Ultrasound elastography assessment of the median nerve in leprosy patients

Nogueira-Barbosa, Marcello Henrique; Lugão, Helena Barbosa; Gregio-Júnior, Everaldo; Crema, Michel D.; Kobayashi, Mariana T.T.; Frade, Marco Andrey Cipriani; Pavan, Theo Z.; Carneiro, Adriana Munhoz

doi:10.1002/mus.25510

Cited by 17 publications

(11 citation statements)

References 25 publications

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“…Relative increase in median nerve stiffness was also found in patients with systemic sclerosis, leprosy, and acromegaly without reported clinical CTS, although only one of three studies reported results of electrodiagnostic studies. [41][42][43] Although the significance of these studies is difficult to ascertain without baseline electrodiagnostic studies, given that the conditions may all be associated with peripheral nerve injury, the results suggest that "cutoff" values for the diagnosis of CTS will differ among patients with other medical conditions affecting the peripheral nervous system, and should not necessarily be stand-alone values to be applied blindly.…”

Section: Cts and The Median Nervementioning

confidence: 98%

Ultrasound elastography for the evaluation of peripheral nerves: A systematic review

Wee

Simon

2019

Muscle and Nerve

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Peripheral nerve disorders are commonly encountered in clinical practice. Electrodiagnostic studies remain the cornerstone of the evaluation of nerve disorders. More recently, ultrasound has played an increasing complementary role in the neuromuscular clinic. Ultrasound elastography is a technique that measures the elastic properties of tissues. Given the histological changes that occur in diseased peripheral nerves, nerve ultrasound elastography has been explored as a noninvasive way to evaluate changes in nerve tissue composition. Studies to date suggest that nerve stiffness tends to increase in the setting of peripheral neuropathy, regardless of etiology, consistent with loss of more compliant myelin, and replacement with connective tissue. The aim of this systematic review is to summarize the current literature on the use of ultrasound elastography in the evaluation of peripheral neuropathy. Limitations of ultrasound elastography and gaps in current literature are discussed, and prospects for future clinical and research applications are raised.

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Section: Cts and The Median Nervementioning

confidence: 98%

Ultrasound elastography for the evaluation of peripheral nerves: A systematic review

Wee

Simon

2019

Muscle and Nerve

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“…and compensates for the limitations of conventional ultrasound in the detection of tumors and other diseases. 63,64 Few studies have assessed changes in the elasticity of the peripheral nerves in diabetic patients with or without diabetic neuropathy, although some studies have demonstrated that such assessment has potential for characterizing diabetic neuropathy. The value of SWE in detecting DPN of the tibial nerve in diabetic DPN patients has been shown to be higher than that of HRU.…”

Section: Improving the Diagnostic Value In Dpn By Shear Wave Sonoelasmentioning

confidence: 99%

Application of High-Resolution Ultrasound on Diagnosing Diabetic Peripheral Neuropathy

Huang¹,

Wu²

2021

DMSO

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Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus (DM). The typical manifestation is a length-dependent "glove and sock" sensation. At present, diagnosis is mainly dependent on clinical manifestations. Since the pathogenesis is not clear, there are no effective treatment measures. Management consists mainly of glucose control, peripheral nerve nutrition, and other measures to delay the progress of the disease; early diagnosis is therefore crucial to improving prognosis and quality of life for patients with DPN. Due to the lack of obvious symptoms in 50% of patients and the low sensitivity of neuro-electrophysiology to small fibers, the missed diagnosis rate is high. Highresolution ultrasound (HRU), as a convenient noninvasive tool, has been proven by many studies to have excellent clinical value in diagnosing DPN. With the development of related new technology, HRU shows promise for the screening, diagnosing, and follow-up of DPN, which could serve as a biomarker and provide new diagnostic insights. In this paper, we review the ability of HRU to detect nerve cross-sectional area and blood flow, and echo and other image changes, and in showing the characteristics of peripheral nerve morphological changes in patients with DPN. We also explore the application of two other recent technological developments-shear wave elastography (SWE) and ultrasound scoring systems-in improving the diagnostic efficiency of HRU in peripheral neuropathy.

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“…Studies vary between describing each of the sonographic features/changes found in leprotic neuropathies, like color Doppler, 32,33 thickening at entrapment sites, 32,34–36 changes in nerve echotexture, 32,34,37,38 diffuse or localized changes of increased CSA of the nerve, 34,35 and/or increased epineural thickness 39 . Even newer techniques such as contrast‐enhanced ultrasound and elastography have been described in leprosy 40,41 . Studies focusing on demonstrating the importance of increased vascularization (intraneural or perineural) interpreted this as a sign of inflammation, and furthermore, as a sign of inflammatory reaction (acute or subacute) in the nerve 32,34,35,42,43 (Figure 6C).…”

Section: Discussionmentioning

confidence: 99%

Exploration of Neurofilament Light Chain and Nerve Ultrasound in Leprotic Neuropathy

Nasr‐Eldin,

Cartwright,

Hamed

et al. 2023

J of Ultrasound Medicine

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ObjectivesTo explore neurofilament light chain (NfL) levels in leprotic neuropathy compared to controls, and to determine if the changes correlate with ultrasonographic nerve findings.MethodsIndividuals with leprosy with signs or symptoms suggestive of peripheral nerve involvement were recruited. They were evaluated by clinical examination, functional scores, laboratory assessments (including NfL), nerve conduction studies (NCS), and ultrasound. Ultrasound was conducted in bilateral median, ulnar, tibial, fibular, sural, and vagus nerves as well as cervical roots 5 and 6. Results were compared to age, sex, and body mass index matched healthy controls.ResultsA total of 320 nerves from 20 patients and 480 nerves from 30 controls were evaluated. NfL was significantly elevated in those with leprosy with a mean and standard deviation of 7.50 + 2.83 compared with 3.42 + 1.18 in controls (P < .001). Ultrasound showed focal enlargement of the nerves, particularly at entrapment sites. Additionally, there were noticeable changes in neural Doppler signal, echogenicity, and epineural thickness among the measured nerve sites. NfL levels in those with leprosy correlated closely with nerve cross‐sectional area at all sites (P < .05). Functional and clinical assessment scores correlated with NfL and sonographic cross‐sectional area as well (P ≤ .05).ConclusionsNfL is elevated in leprotic neuropathy. Ultrasound showed specific morphological changes in individuals with leprosy, and nerve enlargement correlated with NfL levels. Thus, both modalities may be useful for the diagnosis, prognosis, and disease monitoring in those with leprotic neuropathy, and further investigations are warranted.

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Ultrasound elastography assessment of the median nerve in leprosy patients

Abstract: MN/FDSM strain ratios were significantly lower in LP with reactions. UE may be useful for nerve elasticity evaluation in leprosy. Muscle Nerve 56: 393-398, 2017.

Cited by 17 publications

References 25 publications

Ultrasound elastography for the evaluation of peripheral nerves: A systematic review

Ultrasound elastography for the evaluation of peripheral nerves: A systematic review

Application of High-Resolution Ultrasound on Diagnosing Diabetic Peripheral Neuropathy

Exploration of Neurofilament Light Chain and Nerve Ultrasound in Leprotic Neuropathy

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