Zaidman Craig M, Al-Lozi Mohammed, Pestronk Alan
Washington University School of Medicine, Department of Neurology, 660 S. Euclid Avenue, Box 8111, St. Louis, Missouri 63110, USA.
Muscle Nerve. 2009 Dec;40(6):960-6. doi: 10.1002/mus.21431.
Ultrasound has been used for visualizing peripheral nerve pathology. Our goal was to use ultrasound to quantitate the sizes of upper extremity nerves along their length in control subjects and patients with neuropathy. We measured median and ulnar nerve cross-sectional areas (NCSA) in the arms of 190 subjects, including 100 with neuropathies and 90 controls. We found that NCSAs in healthy child and adult controls were greater with increasing height, at proximal sites, and at sites of entrapment. Nerves were enlarged in all Charcot-Marie-Tooth 1A (CMT-1A) (11 of 11; 100%), most chronic inflammatory demyelinating polyneuropathy (CIDP) (31 of 36; 86%), half of Guillain-Barré syndrome (GBS) (8 of 17; 47%), but few axonal neuropathy (7 of 36, 19%) subjects. In GBS, nerve enlargement occurred early and with minimal electrodiagnostic abnormalities in some patients. We conclude that NCSA measured by ultrasound is a quantifiable marker of nerve features that should be corrected for patient characteristics and nerve site. NCSA is generally larger in demyelinating than it is in axonal polyneuropathies.
超声已被用于可视化周围神经病变。我们的目标是使用超声来量化正常对照者和神经病患者上肢神经沿其长度的大小。我们测量了190名受试者手臂的正中神经和尺神经横截面积（NCSA），其中包括100名神经病患者和90名对照者。我们发现，健康儿童和成人对照者的NCSA随着身高增加、在近端部位以及在卡压部位而增大。所有遗传性运动感觉神经病1A型（CMT-1A）患者（11例中的11例；100%）、大多数慢性炎症性脱髓鞘性多发性神经病（CIDP）患者（36例中的31例；86%）、半数吉兰-巴雷综合征（GBS）患者（17例中的8例；47%）的神经增大，但轴索性神经病患者（36例中的7例，19%）神经增大的较少。在GBS中，部分患者神经增大出现得早且电诊断异常轻微。我们得出结论，超声测量的NCSA是一种可量化的神经特征标志物，应根据患者特征和神经部位进行校正。脱髓鞘性多发性神经病的NCSA通常比轴索性多发性神经病的大。
