Center for Neurology, Tübingen University Hospital, Tübingen, Germany; Hertie Institute for Clinical Brain Research, Eberhard-Karls University Tübingen, Tübingen, Germany.
Hans Berger Department of Neurology, Jena University Hospital, Friedrich-Schiller University Jena, Jena, Germany.
Clin Neurophysiol. 2018 Jul;129(7):1403-1409. doi: 10.1016/j.clinph.2018.03.036. Epub 2018 Apr 13.
Reference values are crucial for nerve ultrasound. Here, we reevaluated normal nerve and fascicle cross-sectional area (CSA) values in humans and compared them to published values. Based on these data, ultrasound pattern sum score (UPSS) boundary values were revisited and readjusted.
Ultrasound of different peripheral nerves was performed in 100 healthy subjects at anatomically defined landmarks. Correlations with age, gender, height and weight were calculated.
Overall, correspondence to other published reference values was high. Gender-dependency was found for the proximal median nerve. Dependency from height occurred in the tibial nerve (TN). Weight-dependency was not found. However, the most obvious differences were found in the TN between men >60 years and women <60 years. Thus, general boundary values were defined using the mean plus the twofold standard deviation for all subjects and nerve segments except for the TN, in which different cut-offs were proposed for elder men. Accordingly, the cut-offs for the UPSS were re-adjusted, none of the individuals revealed more than 2 points at maximum.
The influence of distinct epidemiological factors on nerve size is most prominent in the TN, for which thus several normal values are useful.
Adjusted reference values improve the accuracy of the UPSS.
参考值对于神经超声检查至关重要。在这里，我们重新评估了人类正常神经和束横截面面积（CSA）值，并将其与已发表的值进行了比较。基于这些数据，重新审视和调整了超声模式总和评分（UPSS）的边界值。
在解剖定义的标志处对 100 名健康受试者的不同周围神经进行了超声检查。计算了与年龄、性别、身高和体重的相关性。
总体而言，与其他已发表的参考值高度一致。近端正中神经存在性别依赖性。胫骨神经（TN）与身高有关。体重无依赖性。然而，在男性 >60 岁和女性 <60 岁的 TN 之间发现了最明显的差异。因此，除了 TN 之外，使用所有受试者和神经节段的平均值加上两倍标准差定义了一般边界值，在 TN 中为老年男性提出了不同的截止值。因此，重新调整了 UPSS 的截止值，最大程度上没有一个个体超过 2 分。
不同流行病学因素对神经大小的影响在 TN 中最为明显，因此需要几个正常值。
调整后的参考值提高了 UPSS 的准确性。
