Akita J, Miller L H G, Mello F M C, Barreto J A, Moreira A L, Salgado M H, Kirchner D R, Garbino J A
Neurophysiology Division, Lauro de Souza Lima Institute, Brazil.
Clin Neurophysiol Pract. 2021 Mar 17;6:97-102. doi: 10.1016/j.cnp.2021.02.003. eCollection 2021.
To analyze the role of high-resolution ultrasonography with color Doppler (HRUS with CD) to diagnose inflammatory activity (IA) in nerves of leprosy patients under type 1 (RT1) and 2 (RT2) reactions compared to Nerve Conduction Studies (NCS).
Leprosy patients with signs or symptoms suggestive of neuritis (RT1 and RT2) without corticosteroids use were selected. They were evaluated by NCS and subsequently by HRUS with CD. Subacute segmental demyelination and the presence of blood flow, respectively, were considered signs of IA. The two methods were compared for their ability to diagnose patients with leprosy reactions.
A total of 257 nerves from 35 patients were evaluated. NCS and HRUS with CD diagnosed IA in 68% and 74% of patients, respectively. When both methods were used concomitantly, the diagnosis rate was 91.4%. HRUS with CD was particular helpful when there was minimal neurophysiological compromise in NCS or when motor potentials were not detected.
HRUS with CD was able to detect leprosy reactions, especially when combined with NCS. It was especially useful in two opposite situations: nerves with only minor changes and those without motor response in NCS.
Our data shows the usefulness of HRUS and CD, similar to NCS, as a tool to diagnose leprosy reactions.
与神经传导研究（NCS）相比，分析高分辨率彩色多普勒超声（HRUS with CD）在诊断1型（RT1）和2型（RT2）反应下麻风患者神经炎症活动（IA）中的作用。
选择有神经炎体征或症状（RT1和RT2）且未使用皮质类固醇的麻风患者。先对他们进行NCS评估，随后进行HRUS with CD评估。亚急性节段性脱髓鞘和血流情况分别被视为IA的体征。比较这两种方法诊断麻风反应患者的能力。
共评估了35例患者的257条神经。NCS和HRUS with CD分别诊断出68%和74%的患者存在IA。当两种方法同时使用时，诊断率为91.4%。当NCS中神经生理损害最小或未检测到运动电位时，HRUS with CD特别有帮助。
HRUS with CD能够检测麻风反应，尤其是与NCS联合使用时。它在两种相反的情况下特别有用：NCS中仅有轻微变化的神经和无运动反应的神经。
我们的数据表明，HRUS和CD与NCS一样，作为诊断麻风反应的工具是有用的。
