Department of Neurology/Neuromuscular Division, Duke University, North Carolina.
Muscle Nerve. 2020 Jun;61(6):719-725. doi: 10.1002/mus.26819.
Neuromuscular ultrasound is an accepted and valuable element in the evaluation of peripheral nerve and muscle disease. However, ultrasound has several limitations to consider, including operator dependency and lack of a viable contrast agent. Fortunately, new technological advances show promise in resolving these issues. Ultra-high resolution ultrasound enables imaging of the nerve at the fascicular level. Shear wave elastography imaging can provide measures of tissue stiffness that can act as a surrogate measure of nerve and muscle health. Photoacoustic imaging may overcome neuromuscular ultrasound's current lack of contrast agents to detect inflammation and other functional changes within nerve and muscle, while artificial intelligence stands to address operator dependency and improve diagnostic imaging. The basic principles of each of these technologies are discussed along with current research and potential future applications in neuromuscular imaging.
神经肌肉超声是评估周围神经和肌肉疾病的一种被认可且有价值的方法。然而,超声有几个需要考虑的限制,包括操作者依赖性和缺乏可行的对比剂。幸运的是,新技术的进步有望解决这些问题。超高分辨率超声能够在纤维束水平上对神经进行成像。剪切波弹性成像可以提供组织硬度的测量值,可作为神经和肌肉健康的替代测量值。光声成像是一种新兴的神经肌肉超声技术,可克服目前缺乏对比剂的问题,用于检测神经和肌肉内的炎症和其他功能变化,而人工智能则有望解决操作者依赖性问题,并改善诊断成像。本文讨论了这些技术的基本原理,以及它们在神经肌肉成像中的当前研究和潜在未来应用。