Kramer Magdalena, Grimm Alexander, Winter Natalie, Dörner Marc, Grundmann-Hauser Kathrin, Stahl Jan-Hendrik, Wittlinger Julia, Kegele Josua, Kronlage Cornelius, Willikens Sophia
Department of Neurology and Epileptology, Tübingen University Hospital and Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen, 72076 Tübingen, Germany.
Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, University of Zurich, 8008 Zurich, Switzerland.
Diagnostics (Basel). 2021 Jan 31;11(2):211. doi: 10.3390/diagnostics11020211.
Polyneuropathies (PNP) are a broad field of diseases affecting millions of people. While the symptoms presented are mostly similar, underlying causes are abundant. Thus, early identification of treatable causes is often difficult. Besides clinical data and basic laboratory findings, nerve conduction studies are crucial for etiological classification, yet limited. Besides Magnetic Resonance Imaging (MRI), high-resolution nerve ultrasound (HRUS) has become a noninvasive, fast, economic and available tool to help distinguish different types of nerve alterations in neuropathies.
We aim to describe typical ultrasound findings in PNP and patterns of morphological changes in hereditary, immune-mediated, diabetic, metabolic and neurodegenerative PNP. Literature research was performed in PubMed using the terms 'nerve ultrasound', neuromuscular ultrasound, high-resolution nerve ultrasound, peripheral nerves, nerve enlargement, demyelinating, hereditary, polyneuropathies, hypertrophy'.
Plenty of studies over the past 20 years investigated the value of nerve ultrasound in different neuropathies. Next to nerve enlargement, patterns of nerve enlargement, echointensity, vascularization and elastography have been evaluated for diagnostic terms. Furthermore, different scores have been developed to distinguish different etiologies of PNP.
Where morphological alterations of the nerves reflect underlying pathologies, early nerve ultrasound might enable a timely start of available treatment and also facilitate follow up of therapy success.
多发性神经病（PNP）是一个广泛的疾病领域，影响着数百万人。虽然所呈现的症状大多相似，但其潜在病因却多种多样。因此，早期识别可治疗的病因往往很困难。除了临床数据和基本实验室检查结果外，神经传导研究对于病因分类至关重要，但存在局限性。除了磁共振成像（MRI）外，高分辨率神经超声（HRUS）已成为一种无创、快速、经济且可获得的工具，有助于区分神经病中不同类型的神经改变。
我们旨在描述PNP中的典型超声表现以及遗传性、免疫介导性、糖尿病性、代谢性和神经退行性PNP的形态学变化模式。在PubMed上使用“神经超声”、“神经肌肉超声”、“高分辨率神经超声”、“周围神经”、“神经增粗”、“脱髓鞘”、“遗传性”、“多发性神经病”、“肥大”等术语进行文献研究。
过去20年中有大量研究探讨了神经超声在不同神经病中的价值。除了神经增粗外，还对神经增粗模式、回声强度、血管化和弹性成像进行了诊断评估。此外，还开发了不同的评分系统来区分PNP的不同病因。
由于神经的形态学改变反映了潜在的病理状况，早期神经超声检查可能有助于及时开始有效的治疗，并便于对治疗效果进行随访。
