Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Vienna, Austria.
Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Vienna, Austria.
Ultrasound Med Biol. 2020 Jul;46(7):1599-1607. doi: 10.1016/j.ultrasmedbio.2020.02.003. Epub 2020 Apr 9.
The transverse cervical nerve (TCN) is a superficial cutaneous branch of the cervical plexus that innervates the skin of the anterolateral neck. Therefore, it is exposed to injury in anterolateral cervical surgery, which can cause neuropathic pain. To provide a method with which to relieve patients' pain, this study aimed to evaluate the possibility of visualization, diagnostic assessment and blockade of the TCN with high-resolution ultrasound (HRUS). HRUS with high-frequency probes (15-22 MHz), guided ink-marking and consecutive dissection on both sides in nine fresh cadaver necks (n = 18) was conducted. On both sides of 20 healthy volunteers (n = 40), the distances between the greater auricular nerve (GAN) and the TCN at the posterior border of the sternocleidomastoid muscle were measured. Finally, cases referred to HRUS examinations because suspected TCN lesions were assessed. The TCN was visible in all anatomic specimens and in healthy volunteers. Dissection confirmed HRUS findings in all anatomic specimens (100%). In healthy volunteers, the mean distance between the GAN and the TCN was 10.42 ± 3.20 mm. The median visibility, rated on a five-point Likert scale, was four, reflecting good diagnostic quality. There were six patients with visible abnormalities on HRUS. This study confirmed the reliable visualization of the TCN with HRUS in anatomic specimens, healthy volunteers and patients.
颈横神经（TCN）是颈丛的浅表皮支，支配颈前外侧部的皮肤。因此，它在前侧颈路手术中易受损伤，导致神经性疼痛。为了提供一种缓解患者疼痛的方法，本研究旨在评估高分辨率超声（HRUS）对 TCN 的可视化、诊断评估和阻滞的可能性。使用高频探头（15-22 MHz）对 9 具新鲜尸体颈部（n=18）的双侧进行 HRUS 检查，同时进行墨水标记和连续解剖。在 20 名健康志愿者（n=40）的双侧，测量胸锁乳突肌后缘处耳大神经（GAN）与 TCN 之间的距离。最后，对因疑似 TCN 病变而接受 HRUS 检查的病例进行评估。TCN 在所有解剖标本和健康志愿者中均可见。解剖在所有解剖标本中均证实了 HRUS 发现（100%）。在健康志愿者中，GAN 与 TCN 之间的平均距离为 10.42±3.20mm。基于五点 Likert 量表的平均可见度评分为 4，反映了良好的诊断质量。有 6 名患者的 HRUS 可见异常。本研究在解剖标本、健康志愿者和患者中证实了 HRUS 对 TCN 的可靠可视化。
