Walker Francis O, Cartwright Michael S, Wiesler Ethan R, Caress James
Department of Neurology, Wake Forest University School of Medicine Medical Center Boulevard, Winston-Salem, NC 27157-1078, USA.
Clin Neurophysiol. 2004 Mar;115(3):495-507. doi: 10.1016/j.clinph.2003.10.022.
Over the last two decades, ultrasound has developed into a useful technology for the evaluation of diseases of nerve and muscle. Since it is currently not used at by the majority of clinicians involved in diagnosis or care of patients with neuromuscular disorders, this review briefly describes the technical aspects of ultrasound and its physical principles. It relates normal muscle anatomy and movement to ultrasound images in the axial and sagittal planes and follows with a discussion of ultrasound findings in chronic muscle disease. These include evident atrophy and the loss of the hypoechoic architecture of normal muscle tissue. It highlights evolving uses of the technique to measure other pathologic changes in disease including altered muscle dynamics. With high-resolution instruments nerve imaging has now become standard, and the relationships of median nerve anatomy and observations of static and dynamic images from ultrasound are reviewed. Changes seen in carpal tunnel syndrome include significant increases in the cross-sectional area of the nerve just proximal to the site of compression, loss of hyperechoic intensities within nerve, and reduced mobility. Preliminary use of the technique for the study of other nerves is reviewed as well. Ultrasound is an ideal tool for the clinical and research investigation of normal and diseased nerve and muscle complementary to existing diagnostic techniques. As the technology continues to evolve, it will likely assume a more significant role in these areas as those most able to exploit its potential, clinical neurophysiologists and neuromuscular clinicians, incorporate its use at the bedside.
在过去二十年中，超声已发展成为评估神经和肌肉疾病的一项有用技术。由于目前大多数参与神经肌肉疾病患者诊断或护理的临床医生并未使用超声，本综述简要介绍了超声的技术方面及其物理原理。它将正常肌肉解剖结构和运动与轴向和矢状面的超声图像相关联，随后讨论慢性肌肉疾病的超声表现。这些表现包括明显的萎缩以及正常肌肉组织低回声结构的丧失。它强调了该技术在测量疾病中其他病理变化（包括改变的肌肉动力学）方面不断发展的用途。借助高分辨率仪器，神经成像现已成为标准操作，本文还综述了正中神经解剖结构以及超声静态和动态图像观察结果之间的关系。腕管综合征中可见的变化包括在受压部位近端神经的横截面积显著增加、神经内高回声强度丧失以及活动度降低。本文还综述了该技术在研究其他神经方面的初步应用。超声是对正常和患病神经及肌肉进行临床和研究调查的理想工具，可作为现有诊断技术的补充。随着技术不断发展，随着最能够挖掘其潜力的临床神经生理学家和神经肌肉临床医生在床边应用该技术，它在这些领域可能会发挥更重要的作用。
