Department of Radiology and Imaging, Hospital for Special Surgery, 435 East 70th Street, New York, NY, 10021, USA.
Department of Medical Imaging, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada.
Skeletal Radiol. 2021 Sep;50(9):1791-1800. doi: 10.1007/s00256-021-03731-w. Epub 2021 Feb 4.
Characterize the appearance of digital nerve injuries in different ultrasound planes and correlate the presence and size of neuromas with time from injury.
Surgically confirmed nerve injuries were retrospectively evaluated. Appearances of the nerve injury in the available imaging planes were reviewed by two readers. Associations between presence and size of neuroma with time from injury were analyzed.
Injuries of 29 digital nerves (3 incomplete lacerations, 17 complete lacerations, 6 with 7 stump neuromas, 3 neuromas-in-continuity) noted on ultrasound were surgically confirmed. Among the 20 lacerations, long-axis images were obtained in 15, of which 10 depicted the injury and 4 did not. Among the 10 depicting the injury in long axis, 2 showed a discrete gap, and 7 showed the nerve obscured by laceration tissue without a gap. In short axis, the nerve injury was visible in all 20, and nerve laceration was seen as a discrete gap in 2, and obscuration by laceration tissue in 14. Neuromas were hypoechoic and well-defined. There was a positive association between time and presence of neuroma (OR = 1.3, p = 0.002). Correlations between time and cross-sectional area (r = 0.45) and volume (r = 0.57) of neuromas were moderately positive.
Ultrasound long axis may be less useful, and those short axis may be more reliable for assessing digital nerve injuries than previously reported. Neuromas are hypoechoic and well-defined, and their size can vary based on time from injury.
描述不同超声平面下数字神经损伤的外观，并将神经瘤的存在和大小与损伤后的时间相关联。
回顾性评估手术证实的神经损伤。由两名读者对可用成像平面上的神经损伤外观进行了回顾。分析神经瘤的存在和大小与损伤后时间的关系。
超声检查发现 29 条数字神经损伤（3 例不完全撕裂，17 例完全撕裂，6 例伴有 7 个残端神经瘤，3 例神经瘤连续性），均经手术证实。在 20 例撕裂伤中，有 15 例获得了长轴图像，其中 10 例显示了损伤，4 例没有。在 10 例长轴显示损伤的病例中，2 例显示了明显的间隙，7 例显示神经被撕裂组织遮挡而无间隙。在短轴上，所有 20 例均可见神经损伤，2 例可见明显的神经撕裂，14 例可见撕裂组织遮挡神经。神经瘤呈低回声且边界清晰。神经瘤的存在与时间呈正相关（OR = 1.3，p = 0.002）。时间与神经瘤横截面积（r = 0.45）和体积（r = 0.57）之间存在中度正相关。
与之前的报道相比，超声长轴可能不太有用，而短轴可能更可靠地用于评估数字神经损伤。神经瘤呈低回声且边界清晰，其大小可随损伤后时间的变化而变化。
