Druzhinin D S, Naumova E S, Nikitin S S, Novikov M L, Spirin N N, Fedorov A V
Yaroslavl State Medical University, Ministry of Health of Russia, Yaroslavl, Russia.
Society of Experts in Neuromuscular Disease; Medical Center 'Practical Neurology', Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(10):10-13. doi: 10.17116/jnevro201811810110.
To describe the sonographic phenomenon of the focal 'hourglass-like constriction' of the peripheral nerves (FCPN).
The authors described 7 patients meeting the criteria for the diagnosis of neuralgic amyotrophy with unilateral FCPN identified with ultrasound in 4 cases and detected intraoperatively in 3 cases (preliminary ultrasound was not performed). The US scanner Sonoscape Pro mode gray scale in the transverse and longitudinal scanning, linear probe 8-15 MHz and Logiq9 scanner with elastography were used.
FCPN was detected in the single nerve in 4 patients, in two nerves in 2 patients and in 3 nerves in one patient. Among all the nerves involved in the pathological process, the radial nerve and its branches were affected in 73% (8 nerves); the ulnar nerve was involved in 18% (2 nerves) and the musculo-cutaneous nerve in 9%. The length of the constriction of the peripheral nerve did not exceed 1.7 mm. The deformation coefficient (DC) of constriction area was 3.8 to .,9; the change in the elasticity in the form of an increase of DC to 5.9 when compared to the intact portion of the nerve and a decrease in echogenicity were observed in one patient.
High-resolution ultrasound of the nerve can be an informative method for the diagnosis of idiopathic non-traumatic FCPN mononeuropathy.
描述周围神经局灶性“沙漏样狭窄”(FCPN)的超声表现。
作者描述了7例符合神经性肌萎缩诊断标准的患者,其中4例经超声检查发现单侧FCPN,3例在术中发现(未进行术前超声检查)。使用Sonoscape Pro模式灰阶超声仪进行横切和纵切扫描,线性探头频率为8 - 15MHz,以及带有弹性成像功能的Logiq9超声仪。
4例患者的单根神经出现FCPN,2例患者的两根神经出现FCPN,1例患者的三根神经出现FCPN。在所有参与病理过程的神经中,桡神经及其分支受累的占73%(8根神经);尺神经受累的占18%(2根神经),肌皮神经受累的占9%。周围神经狭窄长度不超过1.7mm。狭窄区域的变形系数(DC)为3.8至9;1例患者观察到与神经完整部分相比,狭窄区域的弹性以DC增加至5.9的形式变化,同时回声降低。
神经高分辨率超声检查可为特发性非创伤性FCPN单神经病的诊断提供信息。